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Missouri 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
$223.37 / $237.27 / $276.98
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$195.53 / $237.27 / $406.86
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$235.66 / $235.66 / $274.58
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$157.25 / $195.24 / $342.65
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$473.67 / $473.67 / $569.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$196.77 / $277.26 / $473.51
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$214.46 / $383.00 / $1,261.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$171.58 / $257.42 / $1,509.85
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$247.00 / $718.00 / $1,795.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.81 / $242.68 / $483.25