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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
$60.16 / $60.16 / $60.98
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.64 / $57.74 / $60.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.77 / $71.27 / $121.17
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.56 / $71.81 / $121.17
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$76.09 / $78.58 / $221.24