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Hawaii 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
Professional
Modifier
Low / Median / High Price
$45.71 / $54.95 / $70.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $67.61 / $87.10
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.07 / $72.44 / $85.11
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.77 / $57.54 / $67.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.66 / $63.10 / $85.11
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.90 / $63.10 / $69.18