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Maryland 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
$66.64 / $66.64 / $66.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.44 / $53.39 / $74.27
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.96 / $59.96 / $72.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.65 / $72.97 / $135.82
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.04 / $54.79 / $77.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.74 / $61.06 / $103.72
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.83 / $59.14 / $74.09