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Alaska rates for HCPCS 72114

Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$45.70 / $62.91 / $113.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.39 / $82.79 / $240.55
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$16.17 / $18.98 / $66.06
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$51.21 / $63.78 / $164.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.55 / $174.14 / $220.79
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$22.57 / $50.04 / $53.30
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$69.97 / $122.80 / $170.75
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$146.05 / $178.56 / $378.24
Moda Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$35.58 / $43.07 / $123.63
Moda Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$107.34 / $135.87 / $323.38
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$205.00 / $248.40 / $373.25
Premera BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$55.00 / $61.10 / $96.11
Premera BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$146.25 / $190.35 / $277.14
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.48 / $205.00 / $373.25
Providence
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$49.00 / $64.50 / $97.61
Providence
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$126.08 / $186.00 / $290.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$94.99 / $159.81 / $357.92
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$24.82 / $44.37 / $107.19
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$44.75 / $103.76 / $250.73