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Missouri rates for HCPCS 76380

Computed tomography, limited or localized follow-up study

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$52.04 / $63.14 / $103.89
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$130.90 / $158.36 / $522.99
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$44.69 / $54.43 / $193.80
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$82.58 / $102.40 / $326.76
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$34.79 / $76.42 / $76.42
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.89 / $145.35 / $305.01
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$48.04 / $61.59 / $101.40
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$53.85 / $83.69 / $203.60
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$51.84 / $51.84 / $51.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$113.78 / $202.67 / $348.87
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$39.69 / $65.38 / $115.87
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$76.67 / $134.86 / $244.42
Medica
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$327.27 / $422.56 / $422.56
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$146.88 / $213.44 / $1,035.22
Medica
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$48.44 / $66.68 / $287.12
Medica
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$97.15 / $152.08 / $780.77
Qualchoice
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$81.89 / $81.89 / $81.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$139.54 / $187.40 / $333.38
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$46.58 / $57.90 / $98.88
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$93.00 / $134.69 / $219.51