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South Dakota 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
$45.99 / $45.99 / $46.37
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.00 / $45.99 / $66.53
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.80 / $87.79 / $109.05
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $57.94 / $99.59
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.23 / $91.22 / $276.67
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$81.58 / $100.71 / $110.74
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.57 / $92.91 / $112.87
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.83 / $70.39 / $83.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.23 / $79.43 / $93.45
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.40 / $104.50 / $105.30