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Maine rates for HCPCS 76100

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.44 / $93.33 / $134.90
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$46.77 / $64.57 / $91.20
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $114.82 / $169.82
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$52.48 / $79.43 / $117.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.13 / $123.03 / $223.87
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$54.95 / $85.11 / $158.49
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.33 / $131.83 / $245.47
Harvard Pilgrim
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$70.79 / $89.13 / $177.83
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.86 / $109.65 / $269.15
Martin's Point
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$51.29 / $75.86 / $208.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.20 / $128.82 / $245.47
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$61.66 / $85.11 / $165.96