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Missouri rates for HCPCS 63688

Revision or removal of implanted spinal neurostimulator pulse generator or receiver, with detachable connection to electrode array

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$505.01 / $2,598.00 / $12,154.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$902.00 / $6,799.00 / $40,323.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,083.00 / $10,223.00 / $15,638.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$327.87 / $560.28 / $10,837.41
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,748.00 / $4,449.00 / $9,475.00