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Oklahoma 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
$48.58 / $108.42 / $213.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.87 / $50.59 / $56.93
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.15 / $55.15 / $60.76
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.10 / $68.70 / $80.73
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.25 / $69.13 / $84.98
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.15 / $51.01 / $83.48
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.24 / $68.70 / $332.01
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.24 / $58.36 / $99.64