go back

Pennsylvania rates for HCPCS 76497

Unlisted computed tomography procedure (eg, diagnostic, interventional)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$117.49 / $371.54 / $1,380.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $123.03 / $602.56
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64,565.42 / $64,565.42 / $64,565.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$107.15 / $204.17 / $426.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $138.04 / $331.13
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38,018.94 / $38,018.94 / $38,018.94
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$213.80 / $251.19 / $346.74
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$95.50 / $363.08 / $1,348.96
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $117.49 / $363.08
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.46 / $14.45 / $32.36
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.46 / $14.45 / $32.36
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$131.83 / $234.42 / $309.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $100.00 / $117.49