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New Hampshire 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
Facility
Modifier
Low / Median / High Price
$54.15 / $54.15 / $55.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.11 / $40.63 / $50.32
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.90 / $49.42 / $73.67
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.49 / $67.48 / $132.09
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.31 / $68.16 / $129.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.38 / $63.53 / $140.04
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.49 / $37.76 / $50.66