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Utah rates for HCPCS 64561

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

Facilitymedian $6,918 · 10th–90th $1,349–$20,4170%10%10th90th$6,918Professionalmedian $851 · 10th–90th $302–$2,2910%5%10%10th90th$851$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
$1,348.96 / $6,025.60 / $10,232.93
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $870.96 / $2,290.87
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$512.86 / $512.86 / $1,380.38
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $741.31 / $1,513.56
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $724.44
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,332.54 / $12,882.50 / $19,498.45
Regence BlueShield
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$14,125.38 / $19,498.45 / $29,512.09
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $1,148.15 / $2,290.87
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $794.33 / $1,737.80
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $1,047.13 / $1,778.28
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
$288.40 / $645.65 / $1,288.25