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Missouri rates for HCPCS 74175

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$98.64 / $110.31 / $181.26
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$272.86 / $392.47 / $1,565.46
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$82.23 / $106.03 / $499.77
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$176.33 / $220.00 / $976.14
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$63.50 / $89.58 / $128.33
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$263.64 / $343.90 / $783.50
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$89.39 / $107.41 / $191.24
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$174.26 / $245.32 / $606.95
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$98.06 / $98.06 / $98.06
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$256.89 / $458.82 / $846.44
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$75.02 / $122.28 / $216.85
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$185.92 / $353.51 / $680.51
Medica
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$625.36 / $801.92 / $801.92
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$328.42 / $555.49 / $3,101.53
Medica
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$91.85 / $122.53 / $660.44
Medica
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$232.98 / $422.86 / $2,625.91
Qualchoice
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$155.87 / $155.87 / $155.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$309.66 / $448.00 / $785.37
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$86.07 / $108.20 / $175.09
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$212.10 / $283.42 / $530.90