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Wyoming rates for HCPCS 70487

Computed tomography, maxillofacial area; with contrast material(s)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$51.29 / $51.29 / $51.29
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.91 / $234.42 / $389.05
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$50.12 / $112.20 / $134.90
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$95.50 / $151.36 / $269.15
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.11 / $616.60 / $616.60
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$134.90 / $208.93 / $208.93
BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$263.03 / $407.38 / $407.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.78 / $354.81 / $758.58
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$70.79 / $112.20 / $199.53
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$144.54 / $239.88 / $588.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$263.03 / $331.13 / $933.25
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$54.95 / $102.33 / $199.53
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$177.83 / $223.87 / $724.44