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Pennsylvania rates for HCPCS 74251

Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) study, including glucagon, when administered

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$53.70 / $117.49 / $213.80
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$13.49 / $63.10 / $89.13
Martin's Point
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$60.26 / $112.20 / $204.17
UPMC Health Plan
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$36.31 / $36.31 / $54.95