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Louisiana rates for HCPCS 71250

Diagnostic Computed Tomography Thorax W/O Cntrst

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$53.46 / $61.42 / $86.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$143.28 / $267.14 / $320.00
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$44.14 / $60.00 / $108.28
Aetna
Facility/Professional
Professional
Modifier
52
Low / Median / High Price
$57.93 / $150.00 / $160.00
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$90.34 / $201.03 / $240.00
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.99 / $125.19 / $125.19
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$38.11 / $48.60 / $79.76
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$180.20 / $221.62 / $316.05
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$60.11 / $80.70 / $94.74
BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$120.09 / $143.56 / $223.17
Christus
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$46.45 / $48.85 / $71.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.84 / $162.13 / $343.97
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$33.35 / $60.33 / $103.59
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$50.49 / $97.88 / $250.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$133.01 / $185.71 / $342.77
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$40.95 / $60.72 / $94.18
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$84.17 / $115.08 / $222.72