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Delaware rates for HCPCS 73201

Computed tomography, upper extremity; with contrast material(s)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$54.95 / $61.66 / $144.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.20 / $218.78 / $457.09
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$50.12 / $81.28 / $158.49
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$144.54 / $186.21 / $288.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.98 / $316.23 / $446.68
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$38.90 / $64.57 / $102.33
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$144.54 / $234.42 / $346.74
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$288.40 / $288.40 / $288.40
Highmark BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$53.70 / $53.70 / $53.70
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.78 / $275.42 / $524.81
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$39.81 / $60.26 / $117.49
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$134.90 / $223.87 / $389.05