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Nationwide rates for HCPCS 95972

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 complex spinal cord or peripheral nerve (eg, sacral nerve) neurostimulator pulse generator/transmitter programming by physician or other qualified health care professional

Insurance Carrier	Facility/Professional	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.43 / $59.44 / $135.47	Facility	$42.43	$59.44	$135.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.33 / $60.02 / $113.06	Professional	$38.33	$60.02	$113.06
BCBS Facility/Professional Facility Modifier Low / Median / High Price $95.06 / $293.00 / $876.00	Facility	$95.06	$293.00	$876.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.88 / $72.28 / $131.18	Professional	$44.88	$72.28	$131.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $83.09 / $110.53 / $224.81	Facility	$83.09	$110.53	$224.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.03 / $85.48 / $160.00	Professional	$48.03	$85.48	$160.00
United Facility/Professional Facility Modifier Low / Median / High Price $65.08 / $65.08 / $65.08	Facility	$65.08	$65.08	$65.08
United Facility/Professional Professional Modifier Low / Median / High Price $55.50 / $92.40 / $153.13	Professional	$55.50	$92.40	$153.13

Nationwide rates for HCPCS 95972

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