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Indiana rates for HCPCS 0061U

Transcutaneous measurement of five biomarkers (tissue oxygenation [StO2], oxyhemoglobin [ctHbO2], deoxyhemoglobin [ctHbR], papillary and reticular dermal hemoglobin concentrations [ctHb1 and ctHb2]), using spatial frequency domain imaging (SFDI) and multi-spectral analysis

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.12 / $38.90 / $93.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.85 / $19.95 / $22.91
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.12 / $25.12 / $75.86
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.12 / $38.02 / $52.48
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.55 / $32.36 / $549.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.12 / $25.12 / $25.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.90 / $38.02 / $38.02
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.12 / $25.12 / $25.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.47 / $15.14 / $23.44