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New Hampshire 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
$171.60 / $171.60 / $646.53
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$137.81 / $166.28 / $229.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$172.51 / $267.30 / $814.33
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,500.00 / $2,750.00 / $3,500.00