1602 — Pain Syndrome With Motor Score >= 58.50 And Motor Score < 65.50, No Comorbidity Tier
$4,049
All-payer median here
12
payer/plan-name variants
Median over current-blob negotiated rates (COALESCE of standard / median / min–max midpoint, $0.01–$5M sentinel guard). Payers are canonical-grouped where a mapping exists; unmapped regional-plan name variants may appear as separate rows.