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New York rates for HCPCS 0491T

Ablative laser treatment, non-contact, full field and fractional ablation, open wound, per day, total treatment surface area; first 20 sq cm or less

Insurance Carrier
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,691.00 / $3,382.00 / $4,707.00
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.03 / $11.03 / $12,319.50
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.03 / $11.03 / $11.03