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Pennsylvania rates for HCPCS 74415

Urography, infusion, drip technique and/or bolus technique; with nephrotomography

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$22.32 / $29.81 / $71.42
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$26.26 / $26.26 / $26.26
Martin's Point
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$22.32 / $41.74 / $72.98
Priority Health
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$15.99 / $26.26 / $26.26
UPMC Health Plan
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$22.91 / $22.91 / $26.50