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North Dakota rates for HCPCS 70487

Ct Maxillofacial W/Contrast Material

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$39.77 / $39.77 / $91.17
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.95 / $201.76 / $353.25
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$39.77 / $56.06 / $167.40
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$78.18 / $130.15 / $287.80
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$304.43 / $375.69 / $393.99
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$104.55 / $129.02 / $134.85
BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$199.89 / $246.67 / $258.69
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$60.98 / $60.98 / $60.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$221.85 / $326.20 / $506.00
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$56.48 / $99.60 / $137.97
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$150.76 / $226.26 / $363.11
Medica
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$498.88 / $498.88 / $498.88
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$185.48 / $337.24 / $1,708.01
Medica
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$57.74 / $107.94 / $384.71
Medica
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$122.99 / $223.40 / $2,023.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$185.48 / $320.38 / $717.22
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$62.49 / $100.00 / $141.68
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$111.88 / $206.55 / $391.58