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Indiana rates for HCPCS 01922

Anes Non-Invasive Imaging/Radiation Therapy

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.00 / $640.00 / $720.00
Aetna
Facility/Professional
Professional
Modifier
AA
Low / Median / High Price
$518.24 / $710.18 / $1,233.00
Aetna
Facility/Professional
Professional
Modifier
QK
Low / Median / High Price
$261.00 / $522.00 / $664.70
Aetna
Facility/Professional
Professional
Modifier
QX
Low / Median / High Price
$454.54 / $513.19 / $639.00
Aetna
Facility/Professional
Professional
Modifier
QZ
Low / Median / High Price
$511.44 / $671.27 / $761.36
Ambetter
Facility/Professional
Professional
Modifier
AA
Low / Median / High Price
$233.97 / $416.46 / $880.00
Ambetter
Facility/Professional
Professional
Modifier
QK
Low / Median / High Price
$77.48 / $159.53 / $414.00
Ambetter
Facility/Professional
Professional
Modifier
QX
Low / Median / High Price
$166.24 / $210.70 / $291.74
Ambetter
Facility/Professional
Professional
Modifier
QZ
Low / Median / High Price
$200.60 / $715.00 / $1,050.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$89.10 / $201.45 / $287.64
Cigna
Facility/Professional
Professional
Modifier
QK
Low / Median / High Price
$240.00 / $240.00 / $240.00
Cigna
Facility/Professional
Professional
Modifier
QX
Low / Median / High Price
$240.00 / $240.00 / $240.00