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West 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
$103.50 / $636.38 / $636.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.77 / $39.27 / $47.27
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.53 / $43.33 / $47.21
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.35 / $41.96 / $41.96
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.29 / $60.29 / $60.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.83 / $48.96 / $152.99
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$509.41 / $509.41 / $509.41
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.11 / $48.50 / $70.36