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Missouri 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
$228.93 / $232.12 / $305.24
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.65 / $152.62 / $243.01
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.86 / $170.43 / $255.76
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.65 / $209.09 / $2,505.02
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$171.76 / $268.82 / $6,299.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$166.87 / $253.75 / $423.82