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Maryland 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 $72 · 10th–90th $54–$930%20%10th90th$72Professionalmedian $58 · 10th–90th $38–$1260%10%10th90th$58$50.0$100.0$200.0$500.0

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $57.54 / $125.89
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $45.71 / $66.07
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $79.43 / $154.88
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $63.10 / $95.50
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$53.70 / $72.44 / $93.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $74.13 / $128.82
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $81.28 / $91.20