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Missouri 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
$851.00 / $3,158.00 / $8,118.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$821.00 / $1,963.00 / $5,295.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$287.82 / $458.18 / $12,000.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,695.00 / $5,285.00 / $46,908.00