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Tennessee 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
$38.33 / $78.58 / $2,412.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.33 / $57.36 / $109.77
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.59 / $65.81 / $120.75
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$81.30 / $164.76 / $226.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.16 / $71.70 / $147.50
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$184.85 / $192.38 / $192.38
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.00 / $686.87 / $693.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.19 / $85.27 / $155.72