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Minnesota 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
$44.21 / $68.48 / $120.46
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.61 / $85.79 / $165.92
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.83 / $160.91 / $377.77
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.35 / $148.07 / $296.32