go back

New York 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

Facilitymedian $72 · 10th–90th $43–$1410%10%20%10th90th$72Professionalmedian $60 · 10th–90th $38–$1510%20%10th90th$60$20.0$100.0$500.0$2.0K$10.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$42.66 / $75.86 / $134.90
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $58.88 / $147.91
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $42.66 / $54.95
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $60.26 / $138.04
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57.54 / $57.54 / $57.54
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $57.54 / $79.43
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $173.78 / $245.47
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $89.13 / $229.09
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.12 / $41.69 / $102.33
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $91.20 / $123.03
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $70.79 / $120.23
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$81.28 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $81.28 / $147.91
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$81.28 / $190.55 / $269.15
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $74.13 / $190.55
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$32.36 / $46.77 / $275.42
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $70.79 / $158.49