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Utah 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
$52.96 / $53.36 / $94.81
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.69 / $46.53 / $150.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.82 / $63.78 / $94.59
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.84 / $32.34 / $43.66
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.96 / $64.91 / $82.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.64 / $55.88 / $77.84