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Maine 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
Professional
Modifier
Low / Median / High Price
$165.54 / $165.54 / $197.90
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.38 / $124.18 / $166.28
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.54 / $165.54 / $165.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$172.51 / $231.66 / $364.02