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Maine rates for HCPCS 96567

Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosensitive drug(s), per day

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.82 / $181.97 / $380.19
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.82 / $186.21 / $251.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.15 / $204.17 / $302.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.49 / $186.21 / $288.40
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.04 / $181.97 / $380.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $181.97 / $281.84