go back

Indiana rates for HCPCS 64575

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$285.18 / $1,773.00 / $5,634.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,048.00 / $4,010.00 / $48,326.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$284.49 / $369.84 / $398.29
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,298.55 / $13,298.55 / $15,764.12
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,475.00 / $14,882.00 / $20,461.00