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Illinois 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 $91 · 10th–90th $55–$6030%10%10th90th$91Professionalmedian $63 · 10th–90th $39–$1290%10%10th90th$63$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
$42.66 / $91.20 / $602.56
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $58.88 / $131.83
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $281.84 / $691.83
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $64.57 / $89.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $251.19 / $269.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $77.62 / $158.49
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $93.33 / $416.87
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $50.12 / $75.86
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $33.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $229.09 / $331.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $79.43 / $134.90