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New Mexico rates for HCPCS 0625T

Automated quantification and characterization of coronary atherosclerotic plaque to assess severity of coronary disease, using data from coronary computed tomographic angiography; computerized analysis of data from coronary computed tomographic angiography

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.20 / $36.20 / $36.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.96 / $28.96 / $28.96
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56,799.99 / $68,899.99 / $81,099.99
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $85.00 / $2,445.00
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.50 / $136.50 / $136.50
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,876.07 / $1,876.07 / $4,157.21
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.20 / $50.60 / $74.51