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New Hampshire 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
$60.26 / $147.91 / $147.91
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.44 / $95.50 / $275.42
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$34.67 / $44.67 / $120.23
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$32.36 / $47.86 / $186.21
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.48 / $52.48 / $61.66
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$28.84 / $46.77 / $120.23
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $125.89 / $177.83
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$37.15 / $58.88 / $83.18
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$41.69 / $66.07 / $91.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.33 / $154.88 / $275.42
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$44.67 / $75.86 / $109.65
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$44.67 / $79.43 / $138.04
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $134.90 / $208.93
Harvard Pilgrim
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$42.66 / $66.07 / $97.72
Harvard Pilgrim
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$48.98 / $77.62 / $112.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $120.23 / $208.93
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$38.02 / $52.48 / $97.72
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$40.74 / $56.23 / $128.82
Well Sense
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$23.99 / $28.18 / $28.18