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Pennsylvania rates for HCPCS 74221

Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$31.62 / $63.10 / $114.82
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.20 / $120.23 / $416.87
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$28.84 / $45.71 / $95.50
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$61.66 / $79.43 / $147.91
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$27.54 / $36.31 / $51.29
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.71 / $109.65 / $194.98
Capital Blue Cross
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$33.11 / $34.67 / $66.07
Capital Blue Cross
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$70.79 / $74.13 / $134.90
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$8.13 / $38.02 / $53.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.28 / $131.83 / $208.93
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$23.99 / $41.69 / $67.61
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$58.88 / $91.20 / $151.36
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.20 / $144.54 / $177.83
Emblem Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$32.36 / $42.66 / $52.48
Emblem Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$79.43 / $100.00 / $125.89
Geisinger
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.20 / $117.49 / $218.78
Geisinger
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$31.62 / $37.15 / $69.18
Geisinger
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$56.23 / $79.43 / $151.36
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $131.83 / $138.04
Highmark BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$33.88 / $37.15 / $48.98
Martin's Point
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$31.62 / $61.66 / $114.82
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.33 / $128.82 / $269.15
Martin's Point
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$28.18 / $42.66 / $87.10
Martin's Point
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$63.10 / $87.10 / $173.78
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.88 / $128.82 / $204.17
UPMC Health Plan
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$33.11 / $33.11 / $38.90
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.80 / $63.10 / $165.96
UPMC Health Plan
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$32.36 / $33.11 / $38.90
UPMC Health Plan
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$74.13 / $74.13 / $83.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.13 / $112.20 / $186.21
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$28.18 / $37.15 / $63.10
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$58.88 / $75.86 / $128.82