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Idaho rates for HCPCS 64595

Revision or removal of peripheral, sacral, or gastric neurostimulator pulse generator or receiver, with detachable connection to electrode array

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,407.00 / $4,500.00 / $7,045.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,974.38 / $2,974.38 / $2,982.74
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$184.21 / $325.20 / $677.98
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,513.62 / $8,840.18 / $10,831.01
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,500.00 / $6,878.02 / $17,870.00