go back

Pennsylvania 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
$42.10 / $45.88 / $1,359.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.27 / $45.60 / $68.72
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,000.00 / $8,639.91 / $79,506.39
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.40 / $69.09 / $92.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$62.65 / $88.30 / $217.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.34 / $58.13 / $96.79
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.13 / $70.16 / $94.92
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$509.80 / $509.80 / $509.80
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.10 / $52.12 / $1,812.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.35 / $51.28 / $102.51
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.30 / $51.30 / $123.80
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.40 / $62.65 / $181.59
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.38 / $57.86 / $101.78
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.07 / $38.07 / $46.60
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.07 / $45.44 / $48.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.17 / $55.58 / $103.32