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Wyoming rates for HCPCS 73201

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$52.47 / $52.47 / $53.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$192.27 / $267.52 / $345.16
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$50.07 / $55.67 / $73.44
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$141.11 / $205.53 / $289.50
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$536.00 / $881.00 / $881.00
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$140.00 / $230.00 / $230.00
BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$396.00 / $651.00 / $651.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$290.29 / $425.97 / $702.89
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$63.17 / $95.53 / $166.50
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$212.99 / $316.30 / $550.16
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$255.59 / $396.76 / $881.09
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$49.39 / $103.95 / $179.29
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$206.20 / $321.79 / $701.80