go back

Missouri 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
$36.92 / $48.71 / $86.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.39 / $121.94 / $583.00
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$31.76 / $50.58 / $159.79
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$71.14 / $82.19 / $162.12
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.98 / $89.98 / $89.98
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$29.09 / $47.76 / $54.97
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.94 / $137.00 / $209.80
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$34.38 / $44.81 / $72.00
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$76.56 / $90.19 / $139.44
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$43.57 / $43.57 / $43.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.59 / $145.77 / $243.52
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$30.12 / $48.59 / $83.23
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$61.06 / $100.62 / $170.96
Medica
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$90.13 / $172.60 / $172.60
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.85 / $151.27 / $812.81
Medica
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$35.47 / $54.46 / $240.49
Medica
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$68.70 / $101.87 / $572.32
Qualchoice
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$69.41 / $69.41 / $69.41
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.99 / $134.76 / $231.32
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$35.28 / $43.30 / $72.20
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$68.17 / $88.36 / $159.12