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Nationwide rates for HCPCS 95977

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 complex cranial nerve neurostimulator pulse generator/transmitter programming by physician or other qualified health care professional

Insurance Carrier	Facility/Professional	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $109.65 / $446.68	Facility	$52.48	$109.65	$446.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $54.95 / $120.23	Professional	$46.77	$54.95	$120.23
BCBS Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $288.40 / $1,479.11	Facility	$61.66	$288.40	$1,479.11
BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $63.10 / $104.71	Professional	$42.66	$63.10	$104.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $158.49 / $446.68	Facility	$81.28	$158.49	$446.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $75.86 / $147.91	Professional	$51.29	$75.86	$147.91
United Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $229.09 / $407.38	Facility	$114.82	$229.09	$407.38
United Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $64.57 / $114.82	Professional	$45.71	$64.57	$114.82

Nationwide rates for HCPCS 95977

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