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Massachusetts rates for HCPCS L8687

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,871.31 / $5,871.31 / $5,871.31
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,871.31 / $5,871.31 / $11,290.64
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,398.24 / $47,096.11 / $47,096.11
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,127.34 / $9,310.78 / $16,312.13
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 / $10,140.87
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.43 / $4,618.00 / $9,239.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15,290.18 / $15,290.18 / $16,054.69
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16,496.72 / $47,096.11 / $47,096.11
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,114.52 / $8,732.10 / $15,068.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,114.52 / $8,732.10 / $14,272.59