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Maine rates for HCPCS 96574

Debridement of premalignant hyperkeratotic lesion(s) (ie, targeted curettage, abrasion) followed with 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
Professional
Modifier
Low / Median / High Price
$250.18 / $281.62 / $460.24
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$294.75 / $381.44 / $513.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$243.39 / $357.71 / $637.74
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$333.47 / $399.53 / $591.88
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$250.18 / $306.82 / $460.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.77 / $344.88 / $570.41