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Arizona 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
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.99 / $38.75 / $58.39
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.43 / $39.63 / $50.44
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.43 / $151.81 / $251.44
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.78 / $34.36 / $42.20
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.29 / $60.29 / $60.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.11 / $53.66 / $89.89
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.99 / $38.75 / $75.77
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.58 / $48.72 / $251.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.96 / $42.50 / $83.52