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New Hampshire rates for HCPCS 95970

Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg, contact group[s], interleaving, amplitude, pulse width, frequency [Hz], on/off cycling, burst, magnet mode, dose lockout, patient selectable parameters, responsive neurostimulation, detection algorithms, closed loop parameters, and passive parameters) by physician or other qualified health care professional; with brain, cranial nerve, spinal cord, peripheral nerve, or sacral nerve, neurostimulator pulse generator/transmitter, without programming

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.61 / $67.61 / $154.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.98 / $25.12 / $74.13
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.98 / $21.38 / $28.84
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.85 / $26.30 / $37.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.38 / $35.48 / $70.79
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.05 / $29.51 / $50.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.42 / $32.36 / $66.07
Well Sense
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.80 / $13.80 / $13.80