go back

Idaho rates for HCPCS 74177

Ct Abdomen & Pelvis W/Contrast Material

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$130.09 / $229.75 / $241.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$306.68 / $401.19 / $812.78
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$79.18 / $140.38 / $308.52
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$230.22 / $300.05 / $491.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.95 / $288.31 / $591.44
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$72.26 / $80.76 / $164.29
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$185.71 / $207.55 / $407.59
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,167.11 / $1,167.11 / $1,861.34
Hally Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$689.00 / $689.00 / $690.41
Hally Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$476.71 / $476.71 / $1,172.33
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$490.48 / $564.79 / $744.04
Moda Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$137.69 / $146.04 / $166.90
Moda Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$352.79 / $406.24 / $474.66
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $139.56 / $424.08
Regence BlueShield
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$714.15 / $714.15 / $714.15
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$514.45 / $639.79 / $744.04
Regence BlueShield
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$148.47 / $174.68 / $211.23
Regence BlueShield
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$377.00 / $465.11 / $532.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$282.52 / $349.98 / $664.78
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$74.06 / $98.42 / $179.21
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$203.08 / $251.56 / $461.10