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Pennsylvania rates for HCPCS 74400

Urography (pyelography), intravenous, with or without KUB, with or without tomography

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$26.92 / $64.57 / $89.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.33 / $128.82 / $269.15
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$19.05 / $24.55 / $81.28
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.44 / $72.44 / $72.44
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$6.61 / $19.05 / $19.95
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.82 / $131.83 / $229.09
Capital Blue Cross
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$22.91 / $29.51 / $56.23
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$5.62 / $26.30 / $37.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.20 / $134.90 / $251.19
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$18.20 / $28.84 / $46.77
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $177.83 / $223.87
Emblem Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$22.91 / $30.20 / $37.15
Geisinger
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.18 / $138.04 / $269.15
Geisinger
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$19.95 / $28.18 / $50.12
Highmark BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$12.59 / $25.12 / $26.30
Martin's Point
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$26.92 / $61.66 / $83.18
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.33 / $144.54 / $323.59
Martin's Point
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$19.05 / $26.92 / $61.66
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $125.89 / $251.19
UPMC Health Plan
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$23.44 / $23.44 / $26.30
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.12 / $69.18 / $346.74
UPMC Health Plan
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$22.39 / $23.44 / $26.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $128.82 / $213.80
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$18.62 / $25.12 / $43.65