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Utah 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
$26.92 / $67.61 / $194.98
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.98 / $30.20 / $107.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.99 / $33.11 / $89.13
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $60.26
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$186.21 / $218.78 / $489.78
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.50 / $30.90 / $134.90
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.05 / $30.90 / $46.77
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.44 / $28.18 / $51.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.98 / $26.92 / $70.79