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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
$52.48 / $53.70 / $346.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.77 / $53.70 / $102.33
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.66 / $53.70 / $74.13
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$177.83 / $371.54 / $724.44
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.66 / $57.54 / $85.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.70 / $64.57 / $102.33
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48.98 / $58.88 / $100.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$398.11 / $457.09 / $602.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.77 / $57.54 / $91.20