go back

Montana 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
Professional
Modifier
Low / Median / High Price
$25.70 / $30.90 / $61.66
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.90 / $38.90 / $46.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.92 / $38.90 / $57.54
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41.69 / $43.65 / $47.86
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.69 / $43.65 / $47.86
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.44 / $38.90 / $50.12
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.92 / $56.23 / $79.43
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.90 / $43.65 / $51.29