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Michigan rates for HCPCS 76497

Unlisted computed tomography procedure (eg, diagnostic, interventional)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.72 / $134.90 / $309.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.28 / $123.03 / $302.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$169.82 / $169.82 / $169.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.33 / $173.78 / $457.09
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.72 / $128.82 / $309.03
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.65 / $77.62 / $218.78
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$169.82 / $169.82 / $169.82
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $138.04 / $457.09
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$69.18 / $81.28 / $245.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.10 / $63.10 / $117.49