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New Hampshire rates for HCPCS 75571

Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium

Facilitymedian $25 · 10th–90th $25$520%50%90th$25Professionalmedian $85 · 10th–90th $28$2340%5%10th90th$85$20.0$50.0$100.0$200.0$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$25.12 / $25.12 / $52.48
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $117.49 / $331.13
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$23.99 / $33.11 / $83.18
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$22.91 / $79.43 / $218.78
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $107.15 / $107.15
Ambetter
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$89.13 / $89.13 / $89.13
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $234.42 / $338.84
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$26.92 / $61.66 / $89.13
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$72.44 / $169.82 / $245.47
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $186.21 / $338.84
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$30.20 / $48.98 / $100.00
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$81.28 / $134.90 / $257.04
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $177.83 / $275.42
Harvard Pilgrim
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$30.90 / $47.86 / $70.79
Harvard Pilgrim
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$85.11 / $131.83 / $194.98
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $158.49 / $346.74
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$29.51 / $41.69 / $83.18
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$79.43 / $114.82 / $239.88
Well Sense
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$20.42 / $22.91 / $26.30