go back

New Hampshire 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
$138.06 / $145.06 / $377.65
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$434.18 / $434.18 / $434.18
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.77 / $213.00 / $351.35
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$132.07 / $251.82 / $404.12
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$146.27 / $288.26 / $481.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$166.54 / $233.31 / $460.57
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.22 / $131.06 / $192.66