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Utah rates for HCPCS 74177

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

Facilitymedian $525 · 10th–90th $98$1,9050%20%10th90th$525Professionalmedian $178 · 10th–90th $81$5890%10%10th90th$178$20.0$100.0$500.0$2.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$97.72 / $524.81 / $1,905.46
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $371.54 / $1,737.80
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$77.62 / $117.49 / $354.81
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$218.78 / $281.84 / $1,348.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $389.05 / $660.69
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$77.62 / $107.15 / $186.21
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$199.53 / $269.15 / $478.63
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $478.63
Regence BlueShield
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$676.08 / $676.08 / $676.08
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $524.81 / $676.08
Regence BlueShield
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$120.23 / $141.25 / $204.17
Regence BlueShield
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$316.23 / $380.19 / $478.63
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $457.09 / $691.83
Select Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$81.28 / $177.83 / $269.15
Select Health
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$204.17 / $275.42 / $416.87
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $309.03 / $524.81
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $316.23 / $562.34
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$74.13 / $83.18 / $151.36
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$190.55 / $229.09 / $398.11