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Rhode Island rates for HCPCS 95875

Ischemic Limb Xers Tst Spec Acquisj Metab

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.02 / $128.38 / $165.52
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.15 / $120.18 / $179.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.18 / $159.26 / $275.14
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.51 / $149.08 / $227.17