go back

Iowa rates for HCPCS 76100

Radiologic examination, single plane body section (eg, tomography), other than with urography

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$25.12 / $25.12 / $162.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.79 / $87.10 / $173.78
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$46.77 / $57.54 / $97.72
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$95.50 / $97.72 / $100.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.23 / $208.93 / $263.03
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$81.28 / $147.91 / $181.97
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $125.89 / $208.93
Hally Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$25.70 / $42.66 / $66.07
Hally Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$53.70 / $81.28 / $154.88
Medica
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$97.72 / $123.03 / $123.03
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.33 / $169.82 / $676.08
Medica
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$58.88 / $97.72 / $512.86
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.78 / $199.53 / $223.87
Midlands
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$54.95 / $64.57 / $81.28
Midlands
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$117.49 / $138.04 / $154.88
Midlands
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$100.00 / $100.00 / $100.00
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.83 / $199.53 / $223.87
Midlands
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$114.82 / $138.04 / $154.88
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.18 / $61.66 / $144.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.20 / $120.23 / $213.80
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$61.66 / $81.28 / $141.25
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.36 / $151.36 / $177.83
Wellmark
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$104.71 / $104.71 / $123.03