go back

Pennsylvania rates for HCPCS 64590

Insertion or replacement of peripheral, sacral, or gastric neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$269.37 / $2,747.00 / $29,359.51
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,531.00 / $27,840.00 / $46,296.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$501.84 / $501.84 / $501.84
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,715.46 / $45,296.09 / $80,772.91
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$383.64 / $2,809.00 / $33,315.22
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$501.84 / $501.84 / $501.84
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$156.69 / $188.36 / $290.50
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,742.00 / $8,639.00 / $20,021.00