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Illinois 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
$234.86 / $1,272.00 / $4,634.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,227.56 / $2,720.17 / $5,843.37
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$463.00 / $4,820.95 / $5,382.02
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$253.90 / $485.59 / $1,128.73
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,787.00 / $4,469.00 / $8,566.00