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Utah rates for HCPCS 76497

Unlisted computed tomography procedure (eg, diagnostic, interventional)

Facilitymedian $1,000 · 10th–90th $83–$2,8840%10%20%10th90th$1,000Professionalmedian $123 · 10th–90th $68–$2340%10%20%10th90th$123$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
Typical Low / Median / Typical High
$83.18 / $1,621.81 / $2,884.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $114.82 / $275.42
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $467.74 / $602.56
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $104.71 / $338.84
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $44.67 / $60.26
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $181.97 / $281.84
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $173.78 / $199.53
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $131.83 / $181.97