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Ohio 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 $126 · 10th–90th $45–$4370%10%10th90th$126Professionalmedian $65 · 10th–90th $38–$1410%10%20%10th90th$65$0.5$2.0$10.0$50.0$200.0$1.0K$5.0K

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
$44.67 / $125.89 / $436.52
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $56.23 / $128.82
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $50.12 / $64.57
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $100.00 / $165.96
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$37.15 / $44.67 / $100.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $75.86 / $154.88
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $275.42 / $275.42
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $74.13 / $151.36
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $32.36 / $33.11
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $117.49 / $117.49
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $60.26 / $114.82
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $229.09 / $331.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $70.79 / $125.89