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South Carolina 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
$19.05 / $19.95 / $35.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.33 / $120.23 / $190.55
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$19.05 / $22.91 / $52.48
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $85.11 / $85.11
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$21.88 / $21.88 / $21.88
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.15 / $131.83 / $194.98
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$22.91 / $40.74 / $60.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.50 / $134.90 / $218.78
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$22.39 / $30.90 / $47.86
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.93 / $208.93 / $208.93
Medcost
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$45.71 / $45.71 / $45.71
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.20 / $128.82 / $234.42
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$22.39 / $27.54 / $47.86