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Wisconsin rates for HCPCS 74177

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

Facilitymedian $195 · 10th–90th $166$7940%20%10th90th$195Professionalmedian $245 · 10th–90th $81$1,1220%10%10th90th$245$10.0$50.0$200.0$1.0K$5.0K

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
$93.33 / $194.98 / $288.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $549.54 / $2,884.03
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$81.28 / $112.20 / $691.83
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$213.80 / $288.40 / $588.84
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $478.63 / $1,778.28
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$83.18 / $134.90 / $489.78
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$223.87 / $346.74 / $1,288.25
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $263.03 / $371.54
Cigna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$223.87 / $263.03 / $416.87
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $660.69 / $1,258.93
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$95.50 / $204.17 / $346.74
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$229.09 / $524.81 / $912.01
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $676.08 / $912.01
DeanCare
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$158.49 / $190.55 / $257.04
DeanCare
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$407.38 / $489.78 / $660.69
Medica
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$758.58 / $812.83 / $1,318.26
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $676.08 / $2,089.30
Medica
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$107.15 / $363.08 / $977.24
Medica
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$245.47 / $457.09 / $2,630.27
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $363.08
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $676.08 / $1,122.02
Network Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$117.49 / $204.17 / $331.13
Network Health
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$338.84 / $478.63 / $794.33
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $707.95 / $1,047.13
Quartz
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$199.53 / $794.33 / $794.33
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $1,584.89 / $2,089.30
Quartz
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$95.50 / $446.68 / $549.54
Quartz
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$234.42 / $1,122.02 / $2,630.27
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $831.76 / $831.76
Security Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$229.09 / $229.09 / $229.09
Security Health
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$602.56 / $602.56 / $602.56
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,819.70 / $2,089.30
Security Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$257.04 / $302.00 / $489.78
Security Health
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$602.56 / $707.95 / $1,445.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $1,584.89 / $2,454.71
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$87.10 / $346.74 / $660.69
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$95.50 / $346.74 / $1,621.81