go back

Hawaii rates for HCPCS 96571

Photodynamic therapy by endoscopic application of light to ablate abnormal tissue via activation of photosensitive drug(s); each additional 15 minutes (List separately in addition to code for endoscopy or bronchoscopy procedures of lung and gastrointestinal tract)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,818.38 / $2,818.38 / $2,818.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.91 / $25.12 / $32.36
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.92 / $30.20 / $43.65
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.48 / $39.81 / $44.67
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.70 / $29.51 / $38.02
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,071.52 / $1,071.52 / $1,071.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.55 / $31.62 / $40.74
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.39 / $22.39 / $22.39