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Pennsylvania 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
$42.20 / $53.75 / $158.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.77 / $39.86 / $58.85
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,000.00 / $8,639.91 / $79,506.39
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.74 / $39.15 / $70.73
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.29 / $60.29 / $60.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.60 / $50.82 / $87.31
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.64 / $54.88 / $74.61
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.45 / $97.87 / $338.00
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.96 / $44.67 / $66.83
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.20 / $65.25 / $158.18
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.97 / $43.45 / $102.94
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.90 / $43.90 / $81.09
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.29 / $60.29 / $60.29
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.19 / $50.82 / $89.41
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.95 / $38.90 / $45.17
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.81 / $38.90 / $44.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.38 / $47.30 / $78.23