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Ohio 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
$304.32 / $1,866.00 / $10,268.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,760.00 / $3,576.00 / $16,655.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$203.45 / $258.37 / $323.18
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21,571.00 / $21,571.00 / $21,571.00
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$391.17 / $391.17 / $391.17
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,550.48 / $5,120.00 / $7,853.00