go back

West Virginia 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
$209.55 / $209.55 / $209.55
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$195.53 / $217.83 / $346.19
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$216.41 / $230.36 / $250.99
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.10 / $223.10 / $223.10
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$253.52 / $253.52 / $253.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$192.38 / $260.27 / $442.60
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$277.42 / $277.42 / $303.20
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$460.00 / $460.00 / $460.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$160.87 / $250.26 / $391.29