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Arizona rates for HCPCS 0623T

Automated quantification and characterization of coronary atherosclerotic plaque to assess severity of coronary disease, using data from coronary computed tomographic angiography; data preparation and transmission, computerized analysis of data, with review of computerized analysis output to reconcile discordant data, interpretation and report

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,915.48 / $2,719.98 / $10,286.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.50 / $1,249.81 / $2,107.03
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.26 / $52.87 / $66.09
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$162.41 / $1,249.81 / $5,622.32
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$157.74 / $195.98 / $6,299.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$152.96 / $181.64 / $373.80