go back

Arizona rates for HCPCS 96910

Photochemotherapy; tar and ultraviolet B (Goeckerman treatment) or petrolatum and ultraviolet B

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$201.49 / $201.49 / $201.49
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.42 / $105.56 / $202.86
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.43 / $101.77 / $105.09
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.29 / $257.68 / $408.20
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.61 / $100.81 / $117.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$252.16 / $252.16 / $252.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.13 / $106.50 / $187.18
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48.31 / $110.62 / $165.93
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.68 / $106.53 / $758.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.44 / $104.96 / $134.69