go back

Virginia 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
$77.16 / $131.16 / $2,971.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.00 / $320.06 / $547.46
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$74.45 / $93.03 / $151.87
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$207.19 / $228.41 / $390.60
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$280.80 / $356.08 / $601.10
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$76.66 / $97.56 / $157.30
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$199.74 / $258.87 / $441.18
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$434.80 / $437.42 / $2,931.70
CareFirst
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$96.80 / $107.45 / $150.04
CareFirst
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$323.27 / $340.62 / $466.24
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$98.40 / $98.40 / $98.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$267.64 / $448.82 / $809.85
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$69.70 / $113.57 / $205.49
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$192.16 / $327.08 / $574.22
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$294.36 / $353.23 / $433.17
Kaiser Permanente
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$77.73 / $96.02 / $115.74
Kaiser Permanente
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$216.62 / $259.95 / $318.56
Medcost
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$128.69 / $129.90 / $309.00
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$116.00 / $321.00 / $569.00
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$115.00 / $395.48 / $733.80
Sentara
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$87.12 / $118.63 / $193.10
Sentara
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$236.64 / $322.00 / $536.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$259.73 / $395.57 / $625.32
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$68.59 / $111.53 / $168.32
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$170.42 / $284.04 / $477.25