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Montana rates for HCPCS 0631T

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

Insurance Carrier
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.93 / $136.76 / $136.76
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$118.10 / $139.78 / $159.07