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Indiana rates for HCPCS 95971

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 simple spinal cord or peripheral nerve (eg, sacral nerve) neurostimulator pulse generator/transmitter programming by physician or other qualified health care professional

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.45 / $44.70 / $47.71
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.27 / $43.95 / $56.10
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.34 / $40.34 / $136.75
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.28 / $46.19 / $64.58
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.61 / $46.05 / $54.90
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.77 / $50.23 / $63.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.13 / $54.77 / $103.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.46 / $56.15 / $89.58