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Wyoming 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
$82.95 / $82.95 / $84.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$294.42 / $384.70 / $408.98
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$81.09 / $88.44 / $254.55
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$213.32 / $292.64 / $489.94
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$813.00 / $1,336.00 / $1,336.00
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$220.00 / $362.00 / $362.00
BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$593.00 / $974.00 / $974.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$367.43 / $534.72 / $944.59
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$101.10 / $152.66 / $263.70
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$266.33 / $382.06 / $705.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$289.08 / $598.29 / $1,101.08
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$75.38 / $180.40 / $287.11
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$230.01 / $419.59 / $813.98