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Pennsylvania 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 $59 · 10th–90th $41–$4270%20%10th90th$59Professionalmedian $59 · 10th–90th $38–$1580%20%10th90th$59$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
$40.74 / $58.88 / $426.58
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $57.54 / $162.18
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $42.66 / $54.95
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $67.61 / $120.23
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $213.80 / $257.04
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $81.28 / $141.25
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $91.20 / $123.03
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $85.11 / $154.88
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $181.97 / $3,019.95
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$40.74 / $41.69 / $58.88
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $64.57 / $131.83
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $104.71 / $208.93
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$37.15 / $37.15 / $54.95
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $39.81 / $57.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $281.84 / $323.59
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $67.61 / $117.49