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Virginia 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
$36.27 / $45.60 / $122.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.10 / $45.60 / $73.81
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.61 / $50.28 / $75.59
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.86 / $36.22 / $83.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.70 / $103.71 / $116.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.95 / $61.64 / $102.80
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.79 / $51.68 / $65.14
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.36 / $54.25 / $89.97
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.00 / $79.00 / $102.85
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.93 / $53.13 / $88.94
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.52 / $71.91 / $113.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.40 / $68.23 / $104.52