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Michigan 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
$28.84 / $4,897.79 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.91 / $25.70 / $36.31
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.02 / $25.12 / $42.66
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.67 / $37.15 / $38.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.44 / $33.88 / $42.66
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.84 / $77.62 / $4,897.79
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.12 / $29.51 / $39.81
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.44 / $36.31 / $42.66
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$467.74 / $1,258.93 / $2,041.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.70 / $31.62 / $43.65