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Ohio 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
$415.42 / $2,547.00 / $10,635.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,742.00 / $8,566.00 / $60,294.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$277.31 / $352.19 / $440.52
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21,571.00 / $21,571.00 / $21,571.00
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$354.91 / $354.91 / $354.91
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,873.00 / $10,707.00 / $16,745.00