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Delaware rates for HCPCS 71250

Diagnostic Computed Tomography Thorax W/O Cntrst

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$51.27 / $58.33 / $134.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$135.68 / $221.75 / $687.35
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$44.14 / $52.43 / $87.92
Aetna
Facility/Professional
Professional
Modifier
52
Low / Median / High Price
$63.12 / $71.54 / $85.50
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$79.94 / $146.32 / $201.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$137.04 / $252.92 / $360.45
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$37.08 / $58.82 / $91.72
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$83.01 / $161.16 / $295.50
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$135.63 / $211.13 / $220.49
Highmark BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$49.99 / $64.09 / $513.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$130.68 / $218.89 / $359.37
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$37.53 / $64.83 / $129.37
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$81.87 / $138.74 / $281.44