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Nationwide rates for HCPCS 95976

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 simple cranial nerve neurostimulator pulse generator/transmitter programming by physician or other qualified health care professional

Insurance Carrier	Facility/Professional	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $64.57 / $457.09	Facility	$38.02	$64.57	$457.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $41.69 / $97.72	Professional	$35.48	$41.69	$97.72
BCBS Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $114.82 / $1,479.11	Facility	$48.98	$114.82	$1,479.11
BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $46.77 / $77.62	Professional	$31.62	$46.77	$77.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $83.18 / $281.84	Facility	$47.86	$83.18	$281.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $57.54 / $112.20	Professional	$38.02	$57.54	$112.20
United Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $89.13 / $162.18	Facility	$45.71	$89.13	$162.18
United Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $48.98 / $87.10	Professional	$34.67	$48.98	$87.10

Nationwide rates for HCPCS 95976

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