go back

Alaska rates for HCPCS 76377

3D rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality with image postprocessing under concurrent supervision; requiring image postprocessing on an independent workstation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$117.54 / $117.54 / $117.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.73 / $101.64 / $305.18
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$34.07 / $39.78 / $167.26
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$49.65 / $61.85 / $137.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.42 / $229.52 / $252.07
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$56.91 / $121.03 / $139.15
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$63.51 / $90.37 / $122.50
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$192.45 / $230.94 / $508.97
Moda Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$90.58 / $108.69 / $322.92
Moda Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$96.23 / $122.28 / $278.58
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.25 / $321.30 / $453.71
Premera BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$140.00 / $151.19 / $252.56
Premera BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$114.40 / $164.70 / $206.80
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.10 / $251.25 / $453.71
Providence
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$112.00 / $169.50 / $254.24
Providence
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$110.00 / $152.50 / $201.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$183.62 / $275.43 / $878.00
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$55.73 / $166.80 / $537.00
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$72.29 / $108.45 / $341.00