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Utah rates for HCPCS 76376

3D rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality with image postprocessing under concurrent supervision; not requiring image postprocessing on an independent workstation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$10.96 / $10.96 / $10.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.88 / $57.54 / $288.40
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$8.91 / $10.96 / $48.98
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$12.02 / $26.92 / $109.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.99 / $43.65 / $134.90
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$9.12 / $13.18 / $20.42
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$13.80 / $27.54 / $120.23
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.89 / $32.36 / $41.69
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.88 / $42.66 / $63.10
Regence BlueShield
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$13.18 / $17.38 / $28.18
Regence BlueShield
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$20.42 / $25.70 / $39.81
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.99 / $39.81 / $48.98
Select Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$9.12 / $14.79 / $21.88
Select Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$14.45 / $24.55 / $27.54
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.49 / $25.70 / $47.86
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.95 / $30.20 / $114.82
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$8.32 / $8.71 / $16.98
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$11.22 / $18.62 / $93.33