go back

Indiana 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
Facility
Modifier
Low / Median / High Price
$37.60 / $52.27 / $56.39
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.60 / $53.49 / $102.79
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$95.06 / $95.06 / $183.47
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.75 / $89.70 / $131.18
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.22 / $47.09 / $101.66
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.57 / $59.21 / $74.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.11 / $88.92 / $156.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.87 / $82.01 / $147.91