go back

Idaho rates for HCPCS 64561

Percutaneous implantation of neurostimulator electrode array; sacral nerve (transforaminal placement) including image guidance, if performed

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$882.83 / $2,180.34 / $7,761.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$359.56 / $741.88 / $1,832.22
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$516.03 / $1,419.14 / $1,502.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,263.88 / $6,263.88 / $6,281.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$382.97 / $663.97 / $1,331.26
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$300.04 / $853.16 / $2,216.98
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$485.15 / $1,142.69 / $1,728.87
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $983.63 / $1,237.47
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,328.80 / $17,085.84 / $22,023.84
Regence BlueShield
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$17,927.58 / $25,628.78 / $33,035.76
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$557.19 / $1,042.73 / $1,587.23
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,600.00 / $11,800.00 / $163,191.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$811.67 / $1,186.58 / $1,720.02