go back

New York rates for HCPCS 75574

Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and morphology, assessment of cardiac function, and evaluation of venous structures, if performed)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$112.89 / $138.54 / $301.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$263.20 / $364.49 / $796.74
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$81.04 / $123.09 / $247.48
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$162.63 / $245.65 / $451.66
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$214.61 / $214.61 / $257.44
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$62.69 / $89.55 / $167.46
Ambetter
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$167.89 / $167.89 / $167.89
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$277.02 / $362.12 / $860.85
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$102.44 / $127.21 / $268.01
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$174.58 / $225.55 / $571.64
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$164.33 / $243.77 / $408.10
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$128.94 / $128.94 / $128.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$280.18 / $683.38 / $1,534.16
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$84.34 / $152.68 / $344.96
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$185.71 / $495.77 / $1,008.73
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$337.64 / $457.68 / $779.87
Emblem Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$106.57 / $146.47 / $234.45
Emblem Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$216.39 / $299.95 / $463.36
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$235.67 / $430.87 / $626.54
Excellus BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$94.33 / $163.04 / $235.96
Excellus BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$143.19 / $305.43 / $407.56
Fidelis
Facility/Professional
Professional
Modifier
Low / Median / High Price
$334.49 / $347.53 / $402.40
Fidelis
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$103.43 / $109.05 / $109.09
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$365.87 / $383.23 / $426.85
Highmark BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$115.13 / $160.69 / $237.92
MVP Health Care
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$128.94 / $128.94 / $128.94
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$314.01 / $521.21 / $1,213.04
MVP Health Care
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$85.80 / $152.47 / $338.95
MVP Health Care
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$210.39 / $356.99 / $882.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$288.05 / $449.27 / $978.35
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$94.68 / $130.19 / $318.20
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$195.75 / $290.80 / $649.97
Univera
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$131.63 / $131.63 / $293.62
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$291.12 / $441.45 / $783.15
Univera
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$114.23 / $173.21 / $297.45
Univera
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$176.89 / $310.35 / $474.46