go back

California 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

Facilitymedian $83 · 10th–90th $43–$2880%5%10%10th90th$83Professionalmedian $79 · 10th–90th $40–$2140%5%10th90th$79$20.0$50.0$100.0$200.0$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $102.33 / $338.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $75.86 / $213.80
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $54.95 / $74.13
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $81.28 / $81.28
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $102.33 / $186.21
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$81.28 / $295.12 / $549.54
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $112.20 / $204.17
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $138.04 / $363.08
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $85.11 / $154.88
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $74.13 / $97.72
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $57.54 / $95.50
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $660.69 / $660.69
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $707.95 / $707.95
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $47.86 / $81.28
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $70.79
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$41.69 / $75.86 / $154.88
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $87.10 / $147.91
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $186.21
The Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$35.48 / $97.72 / $177.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$61.66 / $154.88 / $239.88
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $70.79 / $144.54