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Hawaii 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
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.15 / $54.95 / $112.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.88 / $93.33 / $141.25
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $128.82 / $144.54
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.02 / $67.61 / $81.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.66 / $63.10 / $95.50
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.69 / $51.29 / $89.13