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Virginia 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
$49.59 / $57.71 / $130.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.87 / $53.19 / $78.37
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.99 / $59.68 / $90.20
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.96 / $59.96 / $116.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.23 / $72.66 / $120.27
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.77 / $53.92 / $70.09
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48.42 / $61.17 / $92.80
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.00 / $78.17 / $119.83
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53.30 / $71.16 / $120.25
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.06 / $72.08 / $121.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.09 / $72.75 / $110.30