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Idaho 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
$112.20 / $223.87 / $269.15
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.00 / $398.11 / $1,071.52
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$79.43 / $128.82 / $371.54
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$218.78 / $275.42 / $524.81
BCBS
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$707.95 / $707.95 / $707.95
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.63 / $562.34 / $776.25
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$138.04 / $162.18 / $229.09
BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$338.84 / $398.11 / $549.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.04 / $371.54 / $645.65
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$72.44 / $100.00 / $169.82
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$186.21 / $263.03 / $426.58
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,174.90 / $1,174.90 / $1,862.09
Hally Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$691.83 / $691.83 / $691.83
Hally Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$478.63 / $478.63 / $1,174.90
Moda Health
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$125.89 / $229.09 / $269.15
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.84 / $575.44 / $831.76
Moda Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$81.28 / $151.36 / $251.19
Moda Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$245.47 / $407.38 / $562.34
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $199.53
Regence BlueShield
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$707.95 / $707.95 / $707.95
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $630.96 / $758.58
Regence BlueShield
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$141.25 / $173.78 / $218.78
Regence BlueShield
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$323.59 / $467.74 / $549.54
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$281.84 / $288.40 / $776.25
Select Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$79.43 / $79.43 / $186.21
Select Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$199.53 / $223.87 / $758.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$281.84 / $346.74 / $691.83
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$74.13 / $97.72 / $186.21
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$204.17 / $251.19 / $501.19