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Maryland rates for HCPCS 74240

Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$32.88 / $44.77 / $65.43
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.04 / $119.93 / $615.00
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$31.76 / $40.25 / $153.68
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$71.14 / $85.57 / $200.30
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.01 / $126.72 / $144.84
CareFirst
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$34.50 / $36.36 / $41.57
CareFirst
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$63.24 / $90.35 / $102.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.20 / $131.75 / $277.19
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$28.95 / $42.28 / $83.52
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$65.08 / $94.38 / $189.63
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.49 / $146.91 / $219.22
Kaiser Permanente
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$36.13 / $44.33 / $62.55
Kaiser Permanente
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$84.36 / $100.39 / $156.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.08 / $122.34 / $205.93
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$26.74 / $40.47 / $71.08
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$56.85 / $80.84 / $137.77
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.51 / $136.04 / $178.19
Wellpoint
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$27.59 / $41.04 / $55.97
Wellpoint
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$61.92 / $95.61 / $122.23