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New Hampshire rates for HCPCS 95984

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, each additional 15 minutes face-to-face time with physician or other qualified health care professional (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.63 / $47.00 / $773.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.86 / $44.47 / $56.67
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.40 / $54.40 / $84.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.62 / $74.58 / $146.08
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.64 / $77.97 / $146.43
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.48 / $70.47 / $153.07
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.47 / $41.33 / $55.45