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Indiana 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
$107.48 / $176.16 / $232.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.96 / $107.48 / $156.47
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$329.00 / $329.00 / $634.97
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$263.20 / $329.00 / $523.11
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$483.90 / $7,258.52 / $12,198.60
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$474.39 / $474.39 / $677.70
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.77 / $185.21 / $334.66