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Light-Based Measurement Of Tissue Oxygen

Wisconsin rates for HCPCS 0631T

Measures how much oxygen is present in the tissue just beneath the skin by imaging the area with a camera that reads many separate wavelengths of visible light. Nothing is inserted and no blood is taken, and the readings are interpreted and written up in a report.

Rates data updated July 2026.

Facilitymedian $89 · 10th–90th $50$2240%10%10th90th$89Professionalmedian $162 · 10th–90th $85$5130%10%20%10th90th$162$50.0$100.0$200.0$500.0

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
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$50.12
Median
$97.72
Typical High
$223.87
Medica
Setting
Facility
Modifier
Global
Typical Low
$50.12
Median
$77.62
Typical High
$165.96
Medica
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$141.25
Typical High
$512.86
Molina
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$58.88
Typical High
$70.79
Prevea360
Setting
Facility
Modifier
Global
Typical Low
$50.12
Median
$97.72
Typical High
$223.87
Quartz
Setting
Facility
Modifier
Global
Typical Low
$186.21
Median
$512.86
Typical High
$512.86
Quartz
Setting
Professional
Modifier
Global
Typical Low
$331.13
Median
$512.86
Typical High
$512.86
United
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$107.15
Typical High
$107.15