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Wisconsin 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 / $194.98 / $575.44
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $229.09 / $489.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $302.00 / $407.38
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.88 / $275.42 / $371.54
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $194.98 / $724.44
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $181.97
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.93 / $309.03 / $426.58
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.82 / $245.47 / $1,621.81
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.17 / $323.59 / $478.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.03 / $186.21 / $457.09