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Maryland rates for HCPCS 0558T

Computed tomography scan taken for the purpose of biomechanical computed tomography analysis

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$200.63 / $200.63 / $200.63
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$171.00 / $219.78 / $275.00
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$228.27 / $273.92 / $353.91
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.31 / $231.58 / $418.04