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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
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$190.55 / $204.17 / $269.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.49 / $223.87 / $457.09
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,606.93 / $6,606.93 / $6,606.93
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,309.57 / $10,471.29 / $10,471.29