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Idaho 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
$212.50 / $212.50 / $226.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.15 / $56.93 / $77.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.97 / $86.02 / $101.84
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.59 / $71.44 / $85.89
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.53 / $86.76 / $97.68
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $71.42 / $89.86
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$183.30 / $271.68 / $332.87
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.70 / $77.61 / $92.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.58 / $81.93 / $104.72