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Indiana rates for HCPCS 95875

Ischemic Limb Xers Tst Spec Acquisj Metab

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.64 / $127.25 / $147.99
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.72 / $113.50 / $159.94
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.93 / $67.12 / $131.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.14 / $141.38 / $242.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$94.96 / $132.33 / $223.42