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Vermont 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 $178 · 10th–90th $83–$7080%10%10th90th$178Professionalmedian $59 · 10th–90th $39–$1120%10%10th90th$59$50.0$100.0$200.0$500.0

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $83.18 / $114.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $58.88 / $107.15
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $177.83 / $707.95
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $69.18 / $204.17
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $83.18 / $158.49
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $151.36 / $204.17
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $93.33 / $151.36