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Tennessee 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
$50.12 / $100.00 / $102.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.77 / $54.95 / $100.00
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.65 / $45.71 / $52.48
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.48 / $69.18 / $109.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.29 / $67.61 / $112.20
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$323.59 / $323.59 / $323.59
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$331.13 / $416.87 / $416.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.86 / $63.10 / $104.71