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New York rates for HCPCS L8687

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,671.62 / $5,904.74 / $7,368.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,056.17 / $5,979.44 / $7,368.86
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,637.21 / $10,725.96 / $17,807.66
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15,415.48 / $15,415.48 / $15,538.80
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15,415.48 / $15,415.48 / $15,415.48
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 / $6,418.77 / $7,551.49
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11,481.34 / $11,481.34 / $11,481.34
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19,900.00 / $19,900.00 / $19,900.00
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$597.00 / $7,551.49 / $7,551.49
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,418.77 / $6,418.77 / $7,551.49
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,417.52 / $7,056.17 / $13,952.03
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,718.59 / $10,718.59 / $10,718.59
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10,718.59 / $11,481.34 / $11,481.34