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Wisconsin 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
$99.96 / $99.96 / $147.69
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.30 / $384.69 / $1,172.61
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$99.96 / $147.57 / $661.02
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$99.96 / $151.59 / $1,052.35
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.04 / $404.82 / $6,299.47
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $65.00 / $70.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$99.96 / $149.94 / $661.02
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$326.51 / $2,864.61 / $4,085.40
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,363.10 / $5,622.32 / $5,622.32
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,726.20 / $6,299.47 / $6,299.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.04 / $404.82 / $961.15