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Utah 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

Facilitymedian $132 · 10th–90th $63–$1860%20%40%10th90th$132Professionalmedian $58 · 10th–90th $47–$1550%20%10th90th$58$50.0$100.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $64.57 / $181.97
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $54.95 / $181.97
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $77.62 / $114.82
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $117.49
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $181.97 / $275.42
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $66.07 / $102.33
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $83.18 / $97.72
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $75.86 / $112.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $64.57 / $93.33