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Rhode Island 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
$49.80 / $72.50 / $219.37
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.63 / $47.74 / $70.20
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$185.96 / $213.74 / $255.75
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.14 / $40.24 / $57.66
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$457.44 / $457.44 / $457.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.69 / $60.74 / $104.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.09 / $63.22 / $92.62