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Michigan 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
$257.49 / $257.49 / $257.49
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$195.53 / $251.43 / $363.08
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$207.17 / $284.42 / $647.66
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$311.29 / $340.78 / $409.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.65 / $221.82 / $914.76
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$180.76 / $180.76 / $257.49
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$180.76 / $212.31 / $288.95
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.59 / $201.74 / $284.17
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$464.00 / $1,209.00 / $2,029.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$184.42 / $217.62 / $289.44