The total out-of-pocket cost for a vagus nerve stimulator (VNS) implant, such as the Vivistim system used for stroke rehabilitation, varies extensively depending on the specific medical center, geographic location, surgeon fees, and the patient's individual health insurance or Medicare coverage policy. While the device hardware and outpatient surgical implantation procedure combined can total tens of thousands of dollars, insurance pre-authorization and specialized assistance programs often mitigate a significant portion of these expenses for eligible patients.