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Alaska rates for HCPCS L8687

Implantable neurostimulator pulse generator, dual array, rechargeable, includes extension

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,803.92 / $8,803.92 / $8,803.92
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,551.49 / $7,551.49 / $7,551.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,418.77 / $7,551.49 / $7,551.49
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,979.44 / $5,979.44 / $5,979.44
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,535.94 / $8,535.94 / $12,194.20
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,629.42 / $11,629.42 / $34,657.19
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17,970.40 / $34,657.19 / $50,060.40
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,979.44 / $5,979.44 / $8,803.92
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,551.49 / $32,090.00 / $50,060.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,193.87 / $6,214.91 / $11,911.91