go back

South Carolina rates for HCPCS 70487

Ct Maxillofacial W/Contrast Material

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$79.95 / $83.00 / $103.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.16 / $275.00 / $464.46
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$53.37 / $78.56 / $171.08
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$102.02 / $220.00 / $379.60
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$139.69 / $150.18 / $150.18
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$39.97 / $49.98 / $89.46
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$139.69 / $305.73 / $488.29
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$49.98 / $85.00 / $177.72
BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$89.72 / $186.67 / $324.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$167.89 / $296.69 / $514.19
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$57.68 / $76.41 / $136.91
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$109.18 / $226.21 / $369.56
Medcost
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$93.99 / $109.00 / $193.83
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$145.72 / $145.72 / $567.35
Medcost
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$370.94 / $370.94 / $370.94
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.14 / $118.03 / $176.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$157.47 / $222.59 / $457.55
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$55.40 / $75.06 / $121.34
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$103.36 / $176.63 / $339.36