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Ohio 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
$87.24 / $148.30 / $1,489.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$303.52 / $352.69 / $626.50
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$81.65 / $111.40 / $300.25
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$216.29 / $260.57 / $442.33
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$209.85 / $235.04 / $318.00
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$64.09 / $96.66 / $142.91
Ambetter
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$167.31 / $187.53 / $302.02
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$280.80 / $342.58 / $601.10
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$84.26 / $109.64 / $209.69
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$190.00 / $229.90 / $401.12
Aultcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$326.29 / $359.48 / $506.03
Aultcare
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$96.36 / $106.16 / $149.44
Aultcare
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$229.93 / $253.32 / $356.59
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.83 / $246.06 / $387.13
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$89.57 / $98.40 / $98.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$276.52 / $413.99 / $727.46
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$74.79 / $115.46 / $195.53
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$194.86 / $301.14 / $535.73
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$89.57 / $89.57 / $98.40
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$240.00 / $403.87 / $749.94
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$85.74 / $133.21 / $252.51
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$203.64 / $301.14 / $547.26
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.87 / $237.20 / $390.16
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$272.54 / $360.31 / $657.17
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$76.20 / $103.45 / $186.94
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$190.27 / $253.79 / $458.22