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California rates for HCPCS 74177

Computed tomography, abdomen and pelvis; with contrast material(s)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$81.01 / $103.37 / $532.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$301.14 / $375.74 / $1,572.47
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$81.01 / $122.49 / $369.00
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$227.00 / $274.60 / $995.49
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$247.21 / $319.48 / $578.85
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$64.09 / $89.09 / $194.97
Ambetter
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$198.32 / $411.89 / $459.31
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$304.79 / $438.88 / $872.23
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$77.48 / $110.15 / $232.78
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$228.81 / $332.82 / $653.04
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.16 / $394.39 / $980.35
Blue Shield
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$80.98 / $109.71 / $266.93
Blue Shield
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$183.51 / $285.58 / $713.44
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$98.40 / $98.40 / $98.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.48 / $410.83 / $939.11
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$52.44 / $105.97 / $242.66
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$161.04 / $305.25 / $696.65
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$281.80 / $398.55 / $538.04
Contra Costa Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$78.90 / $95.78 / $129.30
Contra Costa Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$202.90 / $302.77 / $408.74
HealthNet
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$97.97 / $97.97 / $181.59
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$286.88 / $395.63 / $636.38
Kaiser Permanente
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$84.84 / $114.94 / $200.93
Kaiser Permanente
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$233.35 / $350.03 / $567.59
Lucent Health
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$791.44 / $791.44 / $805.76
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,077.84 / $2,077.84 / $2,569.28
Lucent Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$547.02 / $547.02 / $697.13
Lucent Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$2,614.00 / $2,614.00 / $2,614.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $254.78
Providence
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$98.40 / $98.40 / $98.40
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$235.00 / $474.25 / $896.78
Providence
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$50.38 / $101.10 / $234.39
Providence
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$150.56 / $295.45 / $665.58
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,091.93 / $1,091.93 / $1,091.93
Sutter Health Plus
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$297.22 / $297.22 / $297.22
Sutter Health Plus
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$794.71 / $794.71 / $794.71
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$322.33 / $394.52 / $479.06
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$276.83 / $344.85 / $825.58
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$74.06 / $96.24 / $224.17
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$203.08 / $238.92 / $799.85