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Idaho rates for HCPCS 76857

Us Pelvic Nonobstetric Image Dcmtn Limited/F/U

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$33.54 / $59.02 / $60.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.79 / $86.47 / $311.95
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$16.92 / $24.10 / $68.44
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$21.16 / $54.66 / $70.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.20 / $75.66 / $124.63
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$21.29 / $35.56 / $47.03
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$25.88 / $38.38 / $76.69
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$247.12 / $247.12 / $427.36
Hally Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$90.49 / $90.49 / $93.49
Hally Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$153.63 / $153.63 / $336.87
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$80.06 / $89.76 / $115.69
Moda Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$37.36 / $39.61 / $45.28
Moda Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$42.70 / $45.29 / $51.76
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $40.60 / $87.96
Regence BlueShield
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$211.40 / $211.40 / $211.40
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.17 / $101.38 / $115.69
Regence BlueShield
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$40.18 / $47.27 / $57.65
Regence BlueShield
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$45.82 / $54.12 / $58.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.44 / $93.15 / $182.75
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$19.05 / $26.60 / $41.67
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$24.18 / $48.36 / $151.83