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Utah rates for HCPCS 64555

Percutaneous implantation of neurostimulator electrode array; peripheral nerve (excludes sacral nerve)

Facilitymedian $3,388 · 10th–90th $282–$9,5500%10%20%10th90th$3,388Professionalmedian $646 · 10th–90th $178–$4,2660%10%10th90th$646$50.0$200.0$1.0K$5.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $3,162.28 / $8,912.51
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $812.83 / $4,265.80
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $323.59 / $3,630.78
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $363.08
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,332.54 / $12,882.50 / $19,498.45
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $588.84 / $4,073.80
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $2,238.72 / $3,630.78
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $2,951.21 / $4,365.16
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,698.24 / $5,128.61 / $75,857.76
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $302.00 / $2,290.87