go back

Pennsylvania rates for HCPCS 71250

Computed tomography, thorax, diagnostic; without contrast material

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$48.98 / $89.13 / $186.21
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $218.78 / $851.14
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$46.77 / $58.88 / $177.83
Aetna
Facility/Professional
Professional
Modifier
52
Low / Median / High Price
$69.18 / $346.74 / $741.31
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$83.18 / $141.25 / $457.09
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.28 / $104.71 / $177.83
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$38.02 / $47.86 / $77.62
Ambetter
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$74.13 / $104.71 / $125.89
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.17 / $478.63 / $478.63
Capital Blue Cross
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$51.29 / $74.13 / $125.89
Capital Blue Cross
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$81.28 / $125.89 / $371.54
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$12.59 / $57.54 / $83.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.83 / $257.04 / $446.68
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$37.15 / $66.07 / $112.20
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$83.18 / $165.96 / $323.59
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.04 / $177.83 / $223.87
Emblem Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$50.12 / $66.07 / $81.28
Emblem Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$89.13 / $114.82 / $144.54
Geisinger
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.04 / $213.80 / $398.11
Geisinger
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$46.77 / $63.10 / $114.82
Geisinger
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$83.18 / $162.18 / $288.40
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.91 / $158.49 / $177.83
Highmark BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$56.23 / $61.66 / $85.11
Highmark BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$125.89 / $151.36 / $245.47
Independence Blue Cross
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$107.15 / $512.86 / $512.86
Martin's Point
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$48.98 / $85.11 / $177.83
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $229.09 / $537.03
Martin's Point
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$47.86 / $64.57 / $162.18
Martin's Point
Facility/Professional
Professional
Modifier
52
Low / Median / High Price
$69.18 / $331.13 / $741.31
Martin's Point
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$85.11 / $144.54 / $323.59
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.86 / $239.88 / $354.81
UPMC Health Plan
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$61.66 / $61.66 / $61.66
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.65 / $181.97 / $288.40
UPMC Health Plan
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$61.66 / $61.66 / $61.66
UPMC Health Plan
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$229.09 / $229.09 / $229.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.83 / $199.53 / $338.84
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$44.67 / $58.88 / $97.72
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$83.18 / $123.03 / $245.47