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Texas 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
$447.92 / $2,280.46 / $6,691.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16,387.50 / $28,919.13 / $59,187.82
Baylor Scott & White
Facility/Professional
Facility
Modifier
Low / Median / High Price
$212.50 / $4,357.68 / $23,794.71
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$261.91 / $21,327.51 / $21,327.51
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$501.84 / $501.84 / $501.84
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,016.24 / $11,500.00 / $22,000.00
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$189.30 / $347.88 / $541.91
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$190.99 / $350.49 / $542.66
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,152.00 / $13,691.00 / $50,448.00