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Virginia rates for HCPCS 74190

Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$19.68 / $35.82 / $84.76
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$25.18 / $25.18 / $25.18
Kaiser Permanente
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$19.50 / $24.09 / $29.52
Medcost
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$32.00 / $34.79 / $68.38