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Texas rates for HCPCS 70486

Computed tomography, maxillofacial area; without contrast material

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$33.11 / $40.74 / $58.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.23 / $213.80 / $676.08
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$37.15 / $57.54 / $186.21
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$83.18 / $125.89 / $295.12
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $112.20 / $194.98
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$30.90 / $38.90 / $69.18
Ambetter
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$58.88 / $69.18 / $128.82
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.11 / $102.33 / $138.04
Baylor Scott & White
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.03 / $199.53 / $407.38
Christus
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$38.02 / $85.11 / $85.11
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$10.00 / $46.77 / $66.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $213.80 / $416.87
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$33.88 / $57.54 / $107.15
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$77.62 / $151.36 / $295.12
Lucent Health
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$371.54 / $371.54 / $371.54
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.49 / $1,380.38 / $1,412.54
Lucent Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$331.13 / $331.13 / $331.13
Lucent Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$1,230.27 / $1,230.27 / $1,230.27
Moda Health
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$33.11 / $38.90 / $57.54
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $223.87 / $512.86
Moda Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$38.02 / $57.54 / $158.49
Moda Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$85.11 / $134.90 / $281.84
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $104.71
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.69 / $131.83 / $467.74
Providence
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$10.00 / $46.77 / $66.07
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $213.80 / $389.05
Providence
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$33.88 / $54.95 / $97.72
Providence
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$77.62 / $147.91 / $288.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.23 / $186.21 / $323.59
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$37.15 / $45.71 / $83.18
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$83.18 / $128.82 / $234.42
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.03 / $123.03 / $154.88
Wellpoint
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$38.90 / $40.74 / $48.98
Wellpoint
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$83.18 / $83.18 / $104.71