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North Carolina 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
$425.50 / $425.50 / $425.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$126.52 / $151.30 / $155.29
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$256.23 / $575.60 / $1,688.40
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$149.66 / $152.03 / $357.17
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$152.03 / $571.47 / $1,714.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,157.73 / $2,820.41 / $3,053.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$161.09 / $223.29 / $523.00
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,104.58 / $6,592.43 / $6,592.43
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,299.47 / $10,389.98 / $10,389.98