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Ohio 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
$50.59 / $161.69 / $445.06
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.87 / $51.83 / $86.76
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.27 / $49.13 / $83.66
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.26 / $57.82 / $94.40
Aultcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.52 / $70.52 / $70.52
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.01 / $53.22 / $69.81
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.36 / $52.36 / $66.64
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.89 / $80.89 / $80.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.75 / $70.73 / $143.41
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.89 / $196.08 / $300.87
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.75 / $70.38 / $115.57
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.25 / $39.86 / $49.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.80 / $68.80 / $125.21