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Hawaii rates for HCPCS L8687

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,368.86 / $7,368.86 / $7,368.86
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,665.94 / $10,665.94 / $10,665.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,551.49 / $7,551.49 / $7,551.49
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29,624.00 / $31,019.88 / $31,019.88
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12,938.31 / $12,938.31 / $12,938.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,922.21 / $9,264.92 / $15,898.61