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Nebraska 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
$214.46 / $214.46 / $214.46
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$212.32 / $245.04 / $840.00
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.99 / $154.99 / $154.99
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,255.69 / $1,651.58 / $3,194.68
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$202.74 / $342.02 / $460.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$214.64 / $468.99 / $586.24
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$214.46 / $375.31 / $1,775.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$328.25 / $395.75 / $562.74
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$356.76 / $422.46 / $619.71
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$331.67 / $395.75 / $544.62
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,056.00 / $1,527.00 / $4,317.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$328.25 / $441.65 / $511.49