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Maryland rates for HCPCS 95875

Ischemic limb exercise test with serial specimen(s) acquisition for muscle(s) metabolite(s)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.60 / $136.07 / $165.69
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.73 / $142.63 / $169.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.19 / $170.25 / $336.29
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.88 / $136.22 / $185.76
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.38 / $135.87 / $264.76
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.79 / $141.72 / $177.15