go back

Louisiana 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
$519.00 / $1,850.00 / $4,926.59
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$3,308.92 / $3,308.92 / $3,308.92
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$333.17 / $696.33 / $1,125.65
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$427.50 / $427.50 / $427.50
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,101.13 / $11,339.16 / $15,801.37
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$374.00 / $724.40 / $1,145.63
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$266.58 / $6,079.31 / $6,079.31
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,200.00 / $1,200.00 / $1,200.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$318.70 / $665.09 / $1,242.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,200.00 / $5,780.00 / $13,506.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$639.23 / $925.04 / $1,699.22