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Vermont 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
$45.08 / $45.08 / $45.90
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.71 / $43.45 / $45.90
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$142.47 / $142.47 / $142.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.76 / $53.63 / $92.47
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.32 / $53.97 / $92.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.09 / $61.27 / $89.78