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California 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
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.12 / $251.19 / $724.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.86 / $56.23 / $173.78
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.67 / $95.50 / $165.96
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.57 / $72.44 / $74.13
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.48 / $81.28 / $151.36
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $123.03 / $302.00
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.95 / $72.44 / $141.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.70 / $69.18 / $131.83
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.77 / $58.88 / $75.86
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.81 / $52.48 / $83.18
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$323.59 / $323.59 / $323.59
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$331.13 / $416.87 / $416.87
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.67 / $44.67 / $75.86
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48.98 / $61.66 / $95.50
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.70 / $70.79 / $131.83
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.78 / $173.78 / $173.78
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.66 / $53.70 / $79.43
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$151.36 / $154.88 / $239.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.65 / $58.88 / $117.49