What is the standard insurance baseline for CPT 01942?

The standard insurance baseline reimbursement rate is $160.09. This represents the customary allowable amount established across standard fee schedules.

Home/Procedures/Anesthesia for Nerve Modulation Procedure Spinal Cord or Repair of Bone of Spine of Lower Back Accessed Through Skin using Imaging Guidance

CPT 01942Medical Service

Anesthesia for Nerve Modulation Procedure Spinal Cord or Repair of Bone of Spine of Lower Back Accessed Through Skin using Imaging Guidance

Q: What do doctors typically charge for Anesthesia for Nerve Modulation Procedure Spinal Cord or Repair of Bone of Spine of Lower Back Accessed Through Skin using Imaging Guidance?

The nationwide median physician charge for Anesthesia for Nerve Modulation Procedure Spinal Cord or Repair of Bone of Spine of Lower Back Accessed Through Skin using Imaging Guidance (CPT 01942) is $1337.43. Doctor billed charges vary based on geographic region, setting, and overhead.

Anesthesia for nerve modulation procedure spinal cord or repair of bone of spine of lower back accessed through skin using imaging guidance. Clinical pricing breakdown and utilization metrics across 461 practicing doctors nationwide.

$1337.43

Peer Median Charge

Gross billed rate

$160.09

Standard Baseline

Customary allowable

8.4x

National Markup

Charge vs baseline

461

Active Physicians

Billing this code

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Understanding This Medical Fee

Gross Charge vs Negotiated Payment: The median physician charge for this service is $1337.43. However, insured patients almost never pay this full amount directly. Insurers negotiate rates down toward the $160.09 baseline.

Self-Pay & Uninsured Guidance: If you are paying without insurance or out-of-network, request a prompt-pay cash discount. Most medical practices are willing to settle self-pay bills near the customary baseline rate rather than the full gross charge.

Key Questions for Your Doctor's Billing Office:

"Does Dr. [Name] participate in my specific insurance plan network?"
"What is the total self-pay or cash rate for code 01942 if paid upfront?"
"Are there separate facility, anesthesia, or pathology fees associated with this procedure?"