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Virginia 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
$36.31 / $37.15 / $229.09
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.67 / $41.69 / $85.11
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.15 / $50.12 / $91.20
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.74 / $45.71 / $64.57
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.26 / $60.26 / $60.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.31 / $52.48 / $83.18
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.92 / $41.69 / $52.48
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.86 / $75.86 / $75.86
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.31 / $44.67 / $74.13
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.48 / $35.48 / $35.48
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.15 / $52.48 / $109.65
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.02 / $53.70 / $112.20
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.23 / $72.44 / $229.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.11 / $52.48 / $83.18