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New York 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
$45.71 / $54.95 / $93.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.67 / $42.66 / $120.23
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.11 / $38.90 / $41.69
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.15 / $43.65 / $74.13
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.23 / $56.23 / $56.23
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.23 / $56.23 / $57.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.26 / $60.26 / $50,118.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.62 / $60.26 / $138.04
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.49 / $36.31 / $81.28
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.90 / $57.54 / $79.43
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.62 / $47.86 / $83.18
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.19 / $2.19 / $275.42
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.66 / $43.65 / $43.65
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.77 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.86 / $57.54 / $102.33
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.86 / $87.10 / $107.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $44.67 / $107.15
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.62 / $44.67 / $54.95
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.62 / $45.71 / $97.72