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North Dakota rates for HCPCS 0102T

Extracorporeal shock wave performed by a physician, requiring anesthesia other than local, and involving the lateral humeral epicondyle

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$189.43 / $189.43 / $8,500.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$189.43 / $215.20 / $337.08
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$189.43 / $373.60 / $512.12
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$285.11 / $541.77 / $637.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$306.95 / $507.51 / $637.27