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Indiana 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
$212.02 / $212.02 / $214.92
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$195.53 / $216.50 / $286.95
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$197.17 / $238.37 / $238.37
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$177.94 / $177.94 / $343.42
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$145.91 / $177.94 / $240.21
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$175.97 / $256.32 / $278.41
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$197.17 / $236.60 / $292.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$203.49 / $234.88 / $370.70
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$866.00 / $2,291.00 / $4,426.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$163.22 / $204.12 / $340.30