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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
$58.88 / $162.18 / $162.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.02 / $58.88 / $117.49
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.48 / $60.26 / $107.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.70 / $85.11 / $128.82
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.65 / $74.13 / $141.25
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$162.18 / $162.18 / $162.18
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.69 / $70.79 / $190.55
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.67 / $75.86 / $125.89