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Nebraska 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
$48.32 / $48.32 / $48.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.99 / $51.47 / $76.28
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.64 / $83.64 / $94.88
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$328.36 / $424.90 / $666.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.85 / $78.45 / $108.73
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.93 / $112.25 / $135.51
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48.32 / $81.54 / $135.88
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.22 / $111.71 / $325.52
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.79 / $121.52 / $137.25
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.03 / $120.24 / $141.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.22 / $111.71 / $126.70