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Idaho rates for HCPCS L8687

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,540.03 / $7,540.03 / $7,540.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,479.70 / $7,479.70 / $8,439.90
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,551.49 / $7,551.49 / $13,206.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,418.77 / $6,418.77 / $7,551.49
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,979.44 / $7,479.70 / $14,555.59
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $55.00 / $10,555.95
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,818.36 / $17,091.14 / $20,008.90
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,344.61 / $9,344.61 / $9,344.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,558.95 / $8,563.54 / $14,272.59