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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
$57.42 / $232.52 / $313.69
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.20 / $53.39 / $108.12
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.17 / $60.75 / $95.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.03 / $91.61 / $160.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.88 / $89.24 / $166.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.31 / $95.23 / $169.83
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.33 / $52.07 / $94.03