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West Virginia 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
$294.24 / $294.24 / $294.24
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,618.34 / $7,164.55 / $15,171.98
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119,998.80 / $119,998.80 / $119,998.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.26 / $215.07 / $609.50