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New Jersey 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
$69.78 / $97.69 / $674.22
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$288.06 / $341.59 / $612.25
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$72.86 / $91.00 / $273.52
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$213.32 / $250.16 / $405.06
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$142.06 / $241.25 / $290.27
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$63.64 / $77.34 / $159.25
Ambetter
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$195.17 / $195.17 / $195.17
AmeriHealth
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.35 / $344.25 / $600.00
AmeriHealth
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$95.55 / $179.00 / $267.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$242.45 / $417.19 / $717.84
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$62.69 / $109.63 / $183.31
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$181.12 / $309.51 / $513.07
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$358.46 / $444.21 / $768.62
Emblem Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$97.60 / $113.75 / $155.93
Emblem Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$260.24 / $313.13 / $424.10
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$272.75 / $320.88 / $510.35
Horizon BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$72.84 / $85.71 / $136.32
Horizon BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$199.90 / $235.18 / $374.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$254.32 / $368.83 / $631.54
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$69.94 / $102.82 / $170.99
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$175.34 / $246.26 / $460.80