go back

Virginia 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
$1,113.22 / $5,087.00 / $10,767.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,900.00 / $13,875.00 / $15,752.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$640.00 / $640.00 / $749.68
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$622.33 / $796.58 / $921.05
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$636.28 / $886.66 / $1,276.67
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$664.75 / $948.90 / $3,131.93
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,621.00 / $20,974.00 / $40,876.00