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Pennsylvania 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 $490 · 10th–90th $107–$1,2300%50%10th90th$490Professionalmedian $102 · 10th–90th $89–$1350%20%40%10th90th$102$2.0$10.0$50.0$200.0$1.0K$5.0K

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $489.78 / $489.78
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $100.00 / $123.03
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $158.49 / $158.49
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $48.98 / $223.87
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $199.53 / $199.53
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $107.15 / $107.15
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $93.33 / $120.23
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $177.83 / $177.83
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $177.83 / $489.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $630.96 / $4,466.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $199.53 / $354.81