go back

Michigan rates for HCPCS 76775

Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$32.74 / $32.74 / $41.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.16 / $101.07 / $246.51
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$25.22 / $32.74 / $108.63
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$29.76 / $62.60 / $128.65
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.40 / $55.64 / $59.31
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$20.28 / $27.32 / $39.14
Ambetter
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$29.50 / $32.13 / $32.13
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.83 / $82.39 / $104.22
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$37.11 / $43.67 / $43.67
BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$45.27 / $53.26 / $53.26
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.38 / $38.42 / $72.33
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$31.27 / $31.27 / $31.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.56 / $88.40 / $184.30
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$22.06 / $33.54 / $78.72
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$25.70 / $46.03 / $114.13
Health Alliance Plan
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$22.56 / $32.74 / $34.36
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.20 / $88.13 / $159.91
Health Alliance Plan
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$22.56 / $32.74 / $94.38
Health Alliance Plan
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$35.25 / $54.62 / $94.41
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.23 / $44.27 / $78.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.70 / $91.20 / $118.88
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$25.89 / $31.16 / $42.50
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$28.80 / $41.70 / $86.52