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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
$54.98 / $71.37 / $143.61
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$196.40 / $272.22 / $335.06
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$50.07 / $52.25 / $82.35
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$144.15 / $222.12 / $276.56
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$197.56 / $316.63 / $392.04
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$39.51 / $60.24 / $99.21
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$146.05 / $248.42 / $317.76
Highmark BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$53.61 / $53.61 / $68.73
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$175.00 / $282.52 / $506.09
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$44.82 / $65.27 / $129.37
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$118.03 / $210.27 / $374.51