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South Carolina 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
$229.09 / $229.09 / $630.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.98 / $234.42 / $446.68
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.54 / $144.54 / $144.54
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$131.83 / $263.03 / $741.31
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.48 / $199.53 / $251.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$181.97 / $181.97 / $181.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.21 / $213.80 / $309.03
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$199.53 / $229.09 / $309.03
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$380.19 / $1,202.26 / $3,548.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.88 / $194.98 / $295.12