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Louisiana 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
$501.19 / $1,288.25 / $3,890.45
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,772.37 / $20,417.38 / $46,773.51
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.81 / $39.81 / $288.40
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$426.58 / $426.58 / $426.58
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,202.26 / $10,000.00 / $24,547.09