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Michigan rates for HCPCS 0695T

Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of implant or replacement

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$144.54 / $144.54 / $144.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $144.54 / $177.83
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$144.54 / $144.54 / $144.54
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.15 / $144.54 / $162.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.18 / $199.53 / $257.04