go back

Pennsylvania 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
$240.03 / $1,978.00 / $7,799.00
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,431.95 / $7,827.00 / $19,139.18
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$391.17 / $391.17 / $391.17
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$940.30 / $7,264.07 / $19,483.03
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$337.07 / $2,070.00 / $8,017.00
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$391.17 / $391.17 / $391.17
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$123.64 / $223.23 / $391.13
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,447.00 / $3,311.00 / $6,000.00