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Alaska rates for HCPCS 0631T

Transcutaneous visible light hyperspectral imaging measurement of oxyhemoglobin, deoxyhemoglobin, and tissue oxygenation, with interpretation and report, per extremity

Insurance Carrier
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.72 / $98.49 / $140.84
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.77 / $289.20 / $441.03
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.33 / $87.06 / $285.62
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.60 / $289.20 / $469.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.88 / $212.18 / $458.07