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Washington rates for HCPCS 74455

Urethrocystography, voiding, radiological supervision and interpretation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$177.83 / $912.01 / $1,348.96
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$25.12 / $34.67 / $56.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.62 / $114.82 / $309.03
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$12.88 / $21.38 / $81.28
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$60.26 / $87.10 / $208.93
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.17 / $204.17 / $204.17
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$26.30 / $26.30 / $28.18
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$478.63 / $870.96 / $1,023.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.28 / $151.36 / $316.23
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$13.80 / $25.12 / $45.71
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$64.57 / $125.89 / $269.15
Kaiser Permanente
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $177.83 / $630.96
Kaiser Permanente
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$18.20 / $30.20 / $630.96
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.18 / $158.49 / $269.15
Kaiser Permanente
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$15.49 / $28.18 / $38.90
Kaiser Permanente
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$67.61 / $131.83 / $234.42
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $57.54
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$128.82 / $181.97 / $208.93
Pacific Source
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$25.12 / $30.20 / $31.62
Pacific Source
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$18.62 / $27.54 / $33.88
Pacific Source
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$83.18 / $120.23 / $177.83
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$141.25 / $141.25 / $144.54
Premera BCBS
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$20.42 / $20.42 / $20.89
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $229.09 / $295.12
Premera BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$20.89 / $33.88 / $45.71
Premera BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$120.23 / $194.98 / $257.04
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$478.63 / $676.08 / $1,318.26
Regence BlueShield
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$446.68 / $446.68 / $446.68
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.91 / $208.93 / $295.12
Regence BlueShield
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$21.38 / $32.36 / $43.65
Regence BlueShield
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$123.03 / $177.83 / $251.19
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$676.08 / $912.01 / $1,621.81
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $107.15 / $257.04
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$14.13 / $17.78 / $39.81
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$64.57 / $89.13 / $218.78
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.65 / $125.89 / $208.93
Wellpoint
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$15.85 / $18.20 / $30.20
Wellpoint
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$95.50 / $109.65 / $177.83