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Washington rates for HCPCS 75774

Angrph Slctv Ea Vsl Studied After Basic Xm Rs&I

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$40.63 / $59.80 / $150.05
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$88.71 / $156.85 / $308.83
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$15.71 / $38.45 / $84.49
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$50.69 / $117.32 / $257.54
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$25.60 / $51.00 / $87.06
Asuris Northwest Health
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$100.00 / $205.87 / $205.87
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.44 / $230.85 / $2,899.89
Asuris Northwest Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$41.38 / $99.78 / $425.60
Asuris Northwest Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$73.33 / $137.44 / $2,808.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.69 / $200.76 / $341.02
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$20.27 / $59.26 / $135.41
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$65.02 / $124.55 / $288.50
Kaiser Permanente
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$16.57 / $35.52 / $103.08
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$94.55 / $197.12 / $457.31
Kaiser Permanente
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$15.95 / $35.99 / $109.91
Kaiser Permanente
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$78.70 / $140.22 / $416.53
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.67 / $102.70 / $228.88
Pacific Source
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$28.50 / $86.87 / $91.79
Pacific Source
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$23.15 / $31.32 / $77.52
Pacific Source
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$83.09 / $129.97 / $241.28
Premera BCBS
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$62.06 / $62.06 / $62.15
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$150.21 / $227.56 / $284.54
Premera BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$66.86 / $106.95 / $129.47
Premera BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$79.48 / $120.47 / $156.31
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.44 / $199.99 / $271.76
Regence BlueShield
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$63.29 / $93.16 / $127.62
Regence BlueShield
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$73.92 / $107.48 / $163.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.27 / $175.15 / $334.21
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$18.80 / $51.07 / $130.16
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$59.91 / $108.57 / $199.81
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.53 / $106.53 / $106.53
Wellpoint
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$47.06 / $47.06 / $47.06
Wellpoint
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$59.47 / $59.47 / $59.47