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Missouri 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
$53.98 / $84.23 / $87.21
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.34 / $54.82 / $97.58
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.12 / $63.12 / $63.12
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,466.00 / $1,641.00 / $25,588.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.12 / $55.77 / $91.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.87 / $74.31 / $115.09
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.44 / $63.52 / $126.04
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.13 / $83.14 / $332.01
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.84 / $68.23 / $118.98