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Washington rates for HCPCS 0631T

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

Facilitymedian $112 · 10th–90th $25–$1580%20%10th90th$112Professionalmedian $138 · 10th–90th $110–$2240%10%20%10th90th$138$50.0$100.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.12 / $67.61 / $114.82
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $269.15
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $60.26 / $79.43
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $158.49 / $158.49
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $109.65 / $109.65
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $151.36 / $229.09
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57.54 / $57.54 / $77.62
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $120.23 / $186.21