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New York 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
$391.80 / $3,317.00 / $10,152.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,977.00 / $10,576.00 / $24,288.00
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$470.36 / $1,254.00 / $4,050.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$354.91 / $354.91 / $354.91
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$332.00 / $552.48 / $1,046.40
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$294.43 / $294.43 / $294.43
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$354.91 / $555.00 / $49,110.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,673.00 / $7,719.00 / $52,889.00
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$366.00 / $366.00 / $1,343.88