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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 $55.16 / $65.27 / $147.29	Facility	$55.16	$65.27	$147.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.44 / $54.82 / $77.55	Professional	$47.44	$54.82	$77.55
BCBS Facility/Professional Facility Modifier Low / Median / High Price $63.45 / $293.00 / $876.00	Facility	$63.45	$293.00	$876.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.99 / $62.82 / $94.40	Professional	$45.99	$62.82	$94.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $80.89 / $80.89 / $80.89	Facility	$80.89	$80.89	$80.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.20 / $72.97 / $121.48	Professional	$53.20	$72.97	$121.48
United Facility/Professional Facility Modifier Low / Median / High Price $59.72 / $59.72 / $59.72	Facility	$59.72	$59.72	$59.72
United Facility/Professional Professional Modifier Low / Median / High Price $50.38 / $68.68 / $115.31	Professional	$50.38	$68.68	$115.31

Nationwide rates for HCPCS 95977

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