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Utah 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
$145.63 / $145.63 / $145.63
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$139.13 / $145.63 / $145.63
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.00 / $45.00 / $60.00
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.69 / $180.78 / $180.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.84 / $161.68 / $270.32