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Indiana rates for HCPCS 76641

Us Breast Uni Real Time With Image Complete

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$32.36 / $38.84 / $41.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.09 / $98.84 / $286.50
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$30.99 / $33.56 / $46.70
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$46.70 / $236.31 / $632.00
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$57.05 / $65.48 / $102.96
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.45 / $74.58 / $80.59
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$25.83 / $38.75 / $72.65
Ambetter
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$108.69 / $114.37 / $157.72
Ambetter
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$95.92 / $95.92 / $135.22
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.79 / $100.14 / $145.56
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$30.55 / $35.38 / $50.23
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$125.68 / $150.21 / $213.29
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$53.24 / $64.76 / $96.94
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.56 / $72.12 / $120.11
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$39.72 / $39.72 / $39.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.05 / $128.90 / $216.88
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$33.43 / $43.84 / $68.29
Cigna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$138.68 / $138.68 / $157.99
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$62.47 / $83.81 / $140.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.64 / $111.93 / $214.58
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$31.59 / $38.17 / $65.83
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$60.39 / $72.28 / $124.46