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Michigan 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
$48.34 / $48.34 / $50.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$80.37 / $94.56 / $205.19
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$35.61 / $41.56 / $119.73
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$40.57 / $56.22 / $115.58
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.77 / $61.98 / $77.76
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$30.27 / $37.10 / $53.43
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.98 / $75.29 / $130.37
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$50.70 / $59.65 / $59.65
BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$67.11 / $67.11 / $67.11
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.21 / $50.44 / $99.02
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$43.19 / $43.19 / $43.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.00 / $114.25 / $214.43
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$29.16 / $48.31 / $93.46
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$29.88 / $57.10 / $158.22
Health Alliance Plan
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$30.70 / $48.34 / $49.21
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.02 / $94.56 / $174.28
Health Alliance Plan
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$30.70 / $41.97 / $104.89
Health Alliance Plan
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$38.31 / $48.34 / $85.53
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.18 / $44.54 / $117.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.48 / $91.13 / $161.18
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$35.00 / $42.28 / $66.43
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$29.94 / $44.66 / $100.09