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Wisconsin rates for HCPCS 74247

Contrst X-Ray Uppr Gi Tract

Insurance Carrier
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$389.28 / $454.91 / $604.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$274.05 / $507.57 / $576.79
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$593.50 / $593.50 / $593.50
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$665.33 / $665.33 / $665.33
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $55.00 / $70.00
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$402.32 / $593.50 / $593.50
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$342.61 / $665.33 / $665.33