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Missouri 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
$42.10 / $58.57 / $133.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.97 / $59.91 / $193.88
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.13 / $95.13 / $95.13
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,466.00 / $1,641.00 / $25,588.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.29 / $79.05 / $132.53
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$249.55 / $277.85 / $369.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.14 / $80.95 / $161.43
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.97 / $64.43 / $143.02
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.47 / $123.10 / $693.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.50 / $83.82 / $141.22