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West Virginia rates for HCPCS L8687

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,268.63 / $4,268.63 / $4,268.63
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,268.63 / $4,671.62 / $6,277.70
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,692.77 / $8,231.75 / $10,737.06
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,551.49 / $7,551.49 / $13,290.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,418.77 / $7,551.49 / $40,025.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,764.02 / $10,592.34 / $15,131.91