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Pennsylvania rates for HCPCS L8687

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

Facilitymedian $4,898 · 10th–90th $4,898–$14,1250%50%90th$4,898Professionalmedian $5,888 · 10th–90th $4,074–$11,2200%20%10th90th$5,888$1.0$10.0$100.0$1.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,897.79 / $4,897.79 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,981.07 / $5,128.61 / $9,772.37
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16,218.10 / $16,218.10 / $16,595.87
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,585.78 / $7,585.78 / $12,022.64
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6,456.54 / $6,456.54 / $7,585.78
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9,772.37 / $9,772.37 / $13,803.84
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,897.79 / $4,897.79 / $4,897.79
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,073.80 / $4,897.79 / $8,709.64
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $27,542.29 / $31,622.78
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14,454.40 / $14,454.40 / $14,454.40
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14,454.40 / $14,454.40 / $14,454.40
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,495.41 / $7,413.10 / $14,125.38
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,677.35 / $7,762.47 / $14,125.38