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Nebraska 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
$108.78 / $108.78 / $108.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.45 / $108.78 / $338.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$231.75 / $304.82 / $589.62
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$105.27 / $177.44 / $239.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.92 / $250.55 / $313.18
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.92 / $136.50 / $238.11
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.72 / $192.87 / $758.33
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$81.70 / $176.10 / $280.75
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.70 / $161.82 / $280.75
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$121.35 / $146.71 / $237.80
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$73.94 / $77.27 / $100.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.31 / $237.87 / $273.04