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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
$27.00 / $67.12 / $67.12
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.23 / $21.58 / $88.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.84 / $32.50 / $88.26
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.14 / $55.63 / $148.97
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$186.54 / $242.20 / $352.96
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.66 / $37.32 / $117.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.70 / $28.05 / $86.86