go back

Virginia 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
$31.20 / $55.86 / $213.87
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$63.29 / $63.29 / $63.29
Kaiser Permanente
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$49.38 / $60.99 / $74.47
Medcost
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$49.85 / $57.00 / $132.36