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Utah rates for HCPCS 95983

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 brain neurostimulator pulse generator/transmitter programming, first 15 minutes face-to-face time with physician or other qualified health care professional

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.60 / $61.39 / $61.39
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.67 / $52.24 / $86.05
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.29 / $72.98 / $108.38
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.84 / $32.34 / $43.66
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$149.41 / $186.30 / $267.47
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.85 / $74.28 / $95.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.72 / $64.23 / $86.65