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South Carolina 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
$53.39 / $54.05 / $75.31
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.46 / $53.39 / $76.28
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.61 / $69.63 / $83.66
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$179.15 / $427.27 / $725.19
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.08 / $65.00 / $99.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.15 / $66.13 / $103.26
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.59 / $63.04 / $111.07
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $40.43 / $61.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.44 / $56.86 / $93.82