Deep Brain Stimulation (DBS) Surgery — Lead & Neurostimulator Implant: Cost Across Insurances
Complete cell-by-cell comparison across Self-Pay Cash, Original Medicare, 6 Major California Commercial Payers (Anthem, Blue Shield, UnitedHealthcare, Aetna, Cigna, Kaiser Permanente), and Medi-Cal — with every cell labeled with its official data source and effective date.
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Hospital procedure cells are extracted from 14 Bay Area hospital MRFs (45 CFR § 180.50, Oct 2026); medication cells use CMS NADAC (as of 2026-10-28) & CY 2026 Medicare Part D / Medi-Cal Rx rules.
| Parkinson's Service / Medication | Self-Pay / Cash Price Hospital MRF / Retail Cash | Medicare Rate 2026 CMS / NADAC / Part D | Anthem Blue Cross MRF Negotiated / Formulary | Blue Shield of CA MRF Negotiated / Formulary | UnitedHealthcare MRF Negotiated / Formulary | Aetna MRF Negotiated / Formulary | Cigna MRF Negotiated / Formulary | Kaiser Permanente MRF Negotiated / Formulary | Medi-Cal (CA Medicaid) CA DHCS / Medi-Cal Rx |
|---|---|---|---|---|---|---|---|---|---|
Pathway ServiceCPT 61885 Deep Brain Stimulation (DBS) Surgery — Lead & Neurostimulator Implant | $337,921 Self-pay discounted cash / negotiated spread ($4,610–$467,890 overall across 14 Bay Area hospitals) Source: 14 Bay Area Hospital MRFs (45 CFR § 180.50) Date: Oct 2026 | $24,865 CMS IPPS/OPPS allowed baseline ($1,648 Part A deductible; $0 with Medigap Plan G/N) Source: CMS CY 2026 Hospital Outpatient Prospective Payment System (APC 5464 Level 4 Neurostimulator Procedures: $24,865) & Inpatient MS-DRG 024 Base Payment ($36,420) under NCD 160.24 Date: CY 2026 (Jan 2026) | $4,792–$233,391 Negotiated across 10 Bay Area hospital MRFs (e.g., UCSF Medical Center (SF): Blue Cross (Anthem Medicare Managed Care Plan) ($60,935); UCSF Medical Center (SF): Blue Cross (Anthem Medi-Cal Managed Care Plan) ($141,490)) Source: Bay Area Hospital MRFs (10/14 facilities, 45 CFR § 180.50) Date: 2026-10-01 | $5,542–$433,931 Negotiated across 11 Bay Area hospital MRFs (e.g., UCSF Medical Center (SF): Blue Shield (Covered California Other Commercial Plan) ($7,145); UCSF Medical Center (SF): Blue Shield (Medicare Managed Care Plan) ($56,425)) Source: Bay Area Hospital MRFs (11/14 facilities, 45 CFR § 180.50) Date: 2026-10-01 | $16,172–$337,921 Negotiated across 14 Bay Area hospital MRFs (e.g., UCSF Medical Center (SF): Unitedhealthcare (Medicare Managed Care Plan) ($54,168); UCSF Medical Center (SF): Unitedhealthcare (Non-Hmo Other Commercial Plan) ($247,121)) Source: Bay Area Hospital MRFs (14/14 facilities, 45 CFR § 180.50) Date: 2026-10-01 | $5,227–$531,679 Negotiated across 13 Bay Area hospital MRFs (e.g., UCSF Medical Center (SF): Aetna (All Commercial Plans) ($144,881); Stanford Hospital (Palo Alto): Aetna (All Commercial Plans) ($16,973)) Source: Bay Area Hospital MRFs (13/14 facilities, 45 CFR § 180.50) Date: 2026-10-01 | $4,610–$415,903 Negotiated across 7 Bay Area hospital MRFs (e.g., UCSF Medical Center (SF): Cigna (All Commercial Plans) ($69,092); Stanford Hospital (Palo Alto): Cigna (Ppo) ($25,837)) Source: Bay Area Hospital MRFs (7/14 facilities, 45 CFR § 180.50) Date: 2026-10-01 | $46,506–$280,734 Negotiated across 2 Bay Area hospital MRFs (e.g., UCSF Medical Center (SF): Kaiser Permanente (All Commercial Plans) ($46,506); Washington Hospital (Fremont): KAISER MCR ADV ($63,861)) Source: Bay Area Hospital MRFs (2/14 facilities, 45 CFR § 180.50) Date: 2026-10-01 | $0 patient copay Medi-Cal Fee-For-Service / Managed Care ($0 beneficiary cost-sharing; provider benchmark ~$19,892) Source: CA DHCS 2026 Medi-Cal Rates & Cost-Sharing Rules Date: Oct 2026 |
Every Insurance Cell for Deep Brain Stimulation (DBS) Surgery — With Source & Date Citations
Self-Pay / Discounted Cash Price
Self-pay discounted cash / negotiated spread ($4,610–$467,890 overall across 14 Bay Area hospitals)
Original Medicare (CMS 2026 / NADAC / Part D)
CMS IPPS/OPPS allowed baseline ($1,648 Part A deductible; $0 with Medigap Plan G/N)
Anthem Blue Cross (California)
Negotiated across 10 Bay Area hospital MRFs (e.g., UCSF Medical Center (SF): Blue Cross (Anthem Medicare Managed Care Plan) ($60,935); UCSF Medical Center (SF): Blue Cross (Anthem Medi-Cal Managed Care Plan) ($141,490))
Blue Shield of California
Negotiated across 11 Bay Area hospital MRFs (e.g., UCSF Medical Center (SF): Blue Shield (Covered California Other Commercial Plan) ($7,145); UCSF Medical Center (SF): Blue Shield (Medicare Managed Care Plan) ($56,425))
UnitedHealthcare (UHC)
Negotiated across 14 Bay Area hospital MRFs (e.g., UCSF Medical Center (SF): Unitedhealthcare (Medicare Managed Care Plan) ($54,168); UCSF Medical Center (SF): Unitedhealthcare (Non-Hmo Other Commercial Plan) ($247,121))
Aetna
Negotiated across 13 Bay Area hospital MRFs (e.g., UCSF Medical Center (SF): Aetna (All Commercial Plans) ($144,881); Stanford Hospital (Palo Alto): Aetna (All Commercial Plans) ($16,973))
Cigna
Negotiated across 7 Bay Area hospital MRFs (e.g., UCSF Medical Center (SF): Cigna (All Commercial Plans) ($69,092); Stanford Hospital (Palo Alto): Cigna (Ppo) ($25,837))
Kaiser Permanente (Northern CA)
Negotiated across 2 Bay Area hospital MRFs (e.g., UCSF Medical Center (SF): Kaiser Permanente (All Commercial Plans) ($46,506); Washington Hospital (Fremont): KAISER MCR ADV ($63,861))
Medi-Cal (California Medicaid / Medi-Cal Rx)
Medi-Cal Fee-For-Service / Managed Care ($0 beneficiary cost-sharing; provider benchmark ~$19,892)
Hospital-by-Hospital Published Rates for Deep Brain Stimulation (DBS) Surgery — Lead & Neurostimulator Implant
| Bay Area Hospital | Self-Pay Cash Price | 2026 Medicare Rate | Negotiated Payer Min–Max | Audited Payer Families |
|---|---|---|---|---|
| UCSF Medical Center (SF) San Francisco • UCSF Health | Not published | $24,865 | $7,145–$176,906 | Blue Shield of California, Medicare Advantage, Cigna, Aetna, Medi-Cal / County Managed Care, Anthem Blue Cross, Health Net, Kaiser Permanente, UnitedHealthcare |
| Stanford Hospital (Palo Alto) Palo Alto • Stanford Medicine | Not published | $24,865 | $13,697–$84,766 | Aetna, Anthem Blue Cross, Blue Shield of California, Medicare Advantage, UnitedHealthcare, Cigna, Medi-Cal / County Managed Care |
| Stanford Tri-Valley (Pleasanton) Pleasanton • Stanford Medicine | Not published | $24,865 | $4,610–$147,104 | Aetna, Blue Shield of California, UnitedHealthcare, Cigna |
| El Camino Health (Mountain View) Mountain View • El Camino Health | Not published | $24,865 | $40,000–$306,186 | Medicare Advantage, Anthem Blue Cross, Health Net, Medi-Cal / County Managed Care, UnitedHealthcare, Blue Shield of California |
| Washington Hospital (Fremont) Fremont • Washington Township Health Care District | $337,921 | $24,865 | $4,813–$467,890 | Medicare Advantage, Blue Shield of California, Health Net, Anthem Blue Cross, UnitedHealthcare, Cigna, Kaiser Permanente, Medi-Cal / County Managed Care, Aetna, Canopy Health |
| CPMC Van Ness (San Francisco) San Francisco • Sutter Health | Not published | $24,865 | $224,758–$250,662 | Aetna, Health Net, UnitedHealthcare, Cigna |
| Alta Bates Medical Center (Berkeley) Berkeley • Sutter Health | Not published | $24,865 | $44,692–$288,240 | Aetna, Blue Shield of California, Cigna, Anthem Blue Cross, Health Net, UnitedHealthcare, Medicare Advantage |
| Summit Medical Center (Oakland) Oakland • Sutter Health | Not published | $24,865 | $44,075–$258,795 | UnitedHealthcare, Cigna, Aetna, Health Net, Medicare Advantage, Medi-Cal / County Managed Care |
| Eden Medical Center (Castro Valley) Castro Valley • Sutter Health | Not published | $24,865 | $43,291–$243,357 | Aetna, UnitedHealthcare, Health Net, Medi-Cal / County Managed Care, Medicare Advantage |
| Mills-Peninsula (Burlingame) Burlingame • Sutter Health | Not published | $24,865 | $42,798–$256,358 | UnitedHealthcare, Aetna, Health Net, Anthem Blue Cross, Medicare Advantage, Medi-Cal / County Managed Care |
| Sutter Delta (Antioch) Antioch • Sutter Health | Not published | $24,865 | $43,302–$243,357 | Aetna, Health Net, UnitedHealthcare, Medicare Advantage |
| Novato Community Hospital (Marin) Novato • Sutter Health | Not published | $24,865 | $210,697–$243,357 | Aetna, UnitedHealthcare, Health Net |
| Sutter Santa Rosa Regional Santa Rosa • Sutter Health | Not published | $24,865 | $48,055–$243,357 | Aetna, Health Net, UnitedHealthcare, Medicare Advantage |
| Sutter Solano (Vallejo) Vallejo • Sutter Health | Not published | $24,865 | $210,697–$228,235 | Aetna, Health Net, UnitedHealthcare |