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Missouri rates for HCPCS 76102

Radiologic examination, complex motion (ie, hypercycloidal) body section (eg, mastoid polytomography), other than with urography; bilateral

Insurance Carrier
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $338.84 / $575.44
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$302.00 / $758.58 / $758.58
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,174.90 / $1,174.90 / $1,174.90
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.31 / $128.82 / $229.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.82 / $186.21 / $354.81