go back

Ohio rates for HCPCS 71275

Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$87.28 / $124.81 / $299.66
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.93 / $374.41 / $732.75
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$81.31 / $97.62 / $289.08
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$170.48 / $268.45 / $565.84
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$212.61 / $220.05 / $280.43
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$63.86 / $95.79 / $149.71
Ambetter
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$156.34 / $156.34 / $156.34
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.06 / $333.90 / $579.09
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$61.06 / $97.06 / $189.48
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$190.00 / $231.80 / $379.14
Aultcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$305.48 / $473.75 / $473.75
Aultcare
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$96.02 / $148.91 / $148.91
Aultcare
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$209.46 / $324.83 / $324.83
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.51 / $223.89 / $362.43
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$89.24 / $98.41 / $98.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$270.52 / $426.81 / $860.03
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$76.70 / $115.24 / $194.80
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$184.78 / $298.80 / $609.75
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$89.24 / $89.24 / $98.41
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$256.66 / $394.74 / $819.59
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$85.43 / $134.10 / $273.62
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$186.39 / $288.58 / $609.75
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.87 / $180.48 / $337.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$268.95 / $369.81 / $667.33
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$77.86 / $105.55 / $187.00
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$183.65 / $273.72 / $481.94