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Utah rates for HCPCS 76497

Unlisted Computed Tomography Procedure

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$89.17 / $1,264.00 / $2,809.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.17 / $95.91 / $171.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$390.00 / $519.00 / $596.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.17 / $125.11 / $227.77
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $45.00 / $60.00
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$133.81 / $174.89 / $251.95
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.63 / $168.62 / $189.32