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West Virginia 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
$460.93 / $2,356.89 / $2,356.89
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$317.39 / $388.91 / $535.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$341.27 / $341.27 / $341.27
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,710.12 / $8,981.94 / $14,031.62