go back

Vermont 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
$43.66 / $43.66 / $63.49
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.19 / $47.08 / $63.49
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.43 / $72.41 / $172.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.46 / $63.06 / $113.52
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.89 / $68.31 / $113.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.98 / $78.22 / $207.28