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Idaho 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
$74.51 / $81.30 / $113.04
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $3,500.00
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53.06 / $66.95 / $90.22
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.92 / $119.90 / $125.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.76 / $115.69 / $154.25