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Indiana rates for HCPCS L8687

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,962.63 / $3,962.63 / $20,698.99
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,892.51 / $3,962.63 / $4,755.16
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,569.91 / $10,569.91 / $20,399.93
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10,569.91 / $10,569.91 / $14,269.37
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,809.41 / $10,477.91 / $24,962.42
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,656.28 / $9,570.35 / $26,210.54
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 / $12,455.99
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,705.97 / $5,739.70 / $13,476.63