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Indiana 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
$48.50 / $49.11 / $88.67
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.80 / $51.30 / $61.97
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.86 / $89.48 / $93.84
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$51.42 / $51.42 / $136.75
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.92 / $51.42 / $70.95
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.83 / $54.90 / $64.98
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.35 / $50.99 / $68.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.98 / $63.51 / $93.34
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.59 / $59.49 / $104.28