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New Hampshire 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
$234.42 / $316.23 / $1,174.90
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.15 / $54.95 / $114.82
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.66 / $42.66 / $54.95
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.67 / $64.57 / $104.71
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.77 / $89.13 / $190.55
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.69 / $74.13 / $141.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.71 / $85.11 / $147.91
Well Sense
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.66 / $42.66 / $42.66