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New Jersey 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
$220.94 / $220.94 / $590.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$172.04 / $220.94 / $417.58
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$219.72 / $219.72 / $219.72
AmeriHealth
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.08 / $275.08 / $275.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$403.23 / $403.23 / $484.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$143.27 / $240.76 / $444.48
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$228.39 / $309.60 / $339.32
Horizon BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$402.71 / $465.27 / $1,047.55
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$189.52 / $259.50 / $376.35
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,341.00 / $2,626.00 / $5,864.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.94 / $217.62 / $426.67