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Utah rates for HCPCS 76497

Unlisted computed tomography procedure (eg, diagnostic, interventional)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.18 / $1,621.81 / $2,884.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $114.82 / $275.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$389.05 / $575.44 / $602.56
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $125.89 / $338.84
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $44.67 / $60.26
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$147.91 / $251.19 / $302.00
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.88 / $181.97 / $208.93
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.90 / $131.83 / $181.97