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Arizona rates for HCPCS 0631T

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

Insurance Carrier
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.53 / $40.01 / $68.88
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.28 / $13.67 / $15.55
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$74.86 / $114.42 / $177.79
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.70 / $93.99 / $515.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.93 / $89.17 / $156.47