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Indiana rates for HCPCS 0631T

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

Insurance Carrier
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.56 / $97.56 / $188.29
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.92 / $169.03 / $256.62
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79.04 / $1,185.60 / $1,958.85
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.58 / $87.24 / $132.00