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Wisconsin 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
$147.80 / $601.40 / $13,935.47
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,123.00 / $18,187.00 / $24,019.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,166.95 / $1,363.67 / $2,091.91
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$158.85 / $312.89 / $601.40
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$164.70 / $365.01 / $20,293.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$158.85 / $289.95 / $601.40
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$595.90 / $948.04 / $1,344.68
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,064.36 / $2,064.36 / $40,421.42
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,078.00 / $19,708.00 / $24,227.00