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Arizona rates for HCPCS 96573

Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosensitizing drug(s) provided by a physician or other qualified health care professional, per day

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$395.77 / $395.77 / $395.77
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$193.28 / $212.31 / $377.15
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$145.47 / $197.44 / $209.91
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$192.66 / $748.88 / $1,186.33
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.84 / $189.12 / $219.85
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$825.32 / $825.32 / $825.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$189.84 / $221.18 / $380.62
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$204.05 / $285.31 / $1,944.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$171.84 / $205.02 / $485.75
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$683.00 / $1,409.00 / $2,175.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$171.84 / $204.06 / $280.31