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Wisconsin 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
Facility
Modifier
Low / Median / High Price
$478.63 / $562.34 / $891.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.42 / $660.69 / $758.58
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$758.58 / $758.58 / $758.58
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,174.90 / $1,174.90 / $1,174.90
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $64.57 / $70.79
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$302.00 / $758.58 / $758.58
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.31 / $1,174.90 / $1,174.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.96 / $177.83 / $275.42