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Idaho rates for HCPCS 64581

Open implantation of neurostimulator electrode array; sacral nerve (transforaminal placement)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,916.25 / $1,916.25 / $7,761.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,571.61 / $6,571.61 / $6,590.08
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$623.69 / $1,363.80 / $1,851.85
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,328.80 / $17,085.84 / $22,023.84
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,800.00 / $12,000.00 / $65,746.00