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New Hampshire 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
$56.01 / $122.59 / $176.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.54 / $43.80 / $63.65
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.95 / $40.95 / $40.95
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.20 / $55.53 / $80.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.44 / $74.39 / $140.88
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.71 / $80.30 / $149.99
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.01 / $81.58 / $142.35
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.79 / $44.21 / $64.26