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Utah rates for HCPCS 0696T

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 follow-up interrogation or programming device evaluation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.02 / $38.02 / $38.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.18 / $40.74 / $47.86
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.67 / $44.67 / $60.26
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.66 / $72.44 / $147.91
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.74 / $43.65 / $47.86
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.98 / $57.54 / $60.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.74 / $52.48 / $66.07