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Wisconsin rates for HCPCS 76380

Computed tomography, limited or localized follow-up study

Facilitymedian $105 · 10th–90th $87$4070%10%20%10th90th$105Professionalmedian $129 · 10th–90th $49$3470%5%10th90th$129$50.0$100.0$200.0$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$87.10 / $87.10 / $93.33
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $162.18 / $302.00
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$43.65 / $54.95 / $107.15
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$75.86 / $104.71 / $218.78
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $204.17 / $758.58
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$43.65 / $70.79 / $257.04
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$87.10 / $134.90 / $512.86
Cigna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$117.49 / $138.04 / $218.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $338.84 / $549.54
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$50.12 / $120.23 / $181.97
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$97.72 / $245.47 / $363.08
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $295.12 / $398.11
DeanCare
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$83.18 / $100.00 / $134.90
DeanCare
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$162.18 / $194.98 / $263.03
Medica
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$426.58 / $426.58 / $426.58
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $316.23 / $1,047.13
Medica
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$50.12 / $100.00 / $288.40
Medica
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$109.65 / $223.87 / $776.25
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $239.88
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $316.23 / $537.03
Network Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$64.57 / $109.65 / $173.78
Network Health
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$134.90 / $208.93 / $363.08
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $331.13 / $588.84
Quartz
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$104.71 / $407.38 / $407.38
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $616.60 / $1,047.13
Quartz
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$57.54 / $239.88 / $288.40
Quartz
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$125.89 / $436.52 / $794.33
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $323.59 / $323.59
Security Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$120.23 / $120.23 / $120.23
Security Health
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$204.17 / $204.17 / $204.17
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $794.33 / $933.25
Security Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$141.25 / $162.18 / $263.03
Security Health
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$309.03 / $346.74 / $562.34
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $257.04 / $524.81
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$83.18 / $213.80 / $346.74
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$97.72 / $173.78 / $346.74