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Maine 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
$43.11 / $59.14 / $160.59
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.11 / $72.14 / $112.21
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.42 / $61.91 / $86.36
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.62 / $77.75 / $123.57
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.64 / $70.06 / $124.37
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$160.59 / $160.59 / $160.59
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.12 / $73.14 / $113.06
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.68 / $81.89 / $125.06