go back

Texas 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
$493.19 / $2,244.00 / $7,513.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,989.27 / $28,340.75 / $56,874.29
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.00 / $286.64 / $289.45
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$354.91 / $354.91 / $354.91
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,461.85 / $12,000.00 / $77,786.45
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$282.20 / $359.17 / $581.25
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$285.18 / $360.09 / $624.54
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,604.00 / $9,624.00 / $50,448.00