go back

Maine rates for HCPCS 76497

Unlisted Computed Tomography Procedure

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$900.00 / $2,163.69 / $2,230.58
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.45 / $91.12 / $123.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.79 / $175.78 / $346.67
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.82 / $446.82 / $446.82
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$900.00 / $900.00 / $2,163.69
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.45 / $91.12 / $171.00