go back

Vermont 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
$60.26 / $60.26 / $60.26
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.77 / $56.23 / $114.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.10 / $72.44 / $120.23
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.57 / $75.86 / $186.21
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.66 / $79.43 / $151.36