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Maine 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
$42.50 / $52.56 / $156.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.35 / $52.56 / $68.72
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.26 / $59.80 / $74.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.34 / $71.12 / $107.04
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.40 / $58.94 / $104.61
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$156.10 / $156.10 / $156.10
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.19 / $52.56 / $75.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.39 / $70.56 / $108.81