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Washington, DC 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 $54 · 10th–90th $37–$540%20%40%10th$54Professionalmedian $55 · 10th–90th $38–$1700%10%10th90th$55$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
$37.15 / $37.15 / $53.70
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $53.70 / $169.82
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $45.71 / $281.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $93.33 / $239.88
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $74.13 / $128.82
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$389.05 / $457.09 / $537.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $85.11 / $169.82