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New Mexico rates for HCPCS 0523T

Intraprocedural coronary fractional flow reserve (FFR) with 3D functional mapping of color-coded FFR values for the coronary tree, derived from coronary angiogram data, for real-time review and interpretation of possible atherosclerotic stenosis(es) intervention (List separately in addition to code for primary procedure)

Facilitymedian $1,318 · 10th–90th $170–$69,1830%10%10th90th$1,318Professionalmedian $115 · 10th–90th $89–$1480%20%40%10th90th$115$100.0$500.0$2.0K$10.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $114.82 / $114.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $114.82 / $147.91
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56,234.13 / $69,183.10 / $81,283.05
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $85.11
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$93.33 / $169.82 / $257.04
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $1,148.15 / $1,412.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $239.88 / $316.23