go back

Arizona rates for HCPCS 74775

Perineogram (eg, vaginogram, for sex determination or extent of anomalies)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$281.84 / $281.84 / $281.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.88 / $204.17 / $288.40
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$173.78 / $562.34 / $831.76
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.78 / $269.15 / $489.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$74.13 / $257.04 / $724.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.18 / $102.33 / $173.78
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.36 / $158.49 / $512.86
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $263.03 / $562.34
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.81 / $204.17 / $338.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $257.04 / $371.54