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Kentucky rates for HCPCS 76857

Us Pelvic Nonobstetric Image Dcmtn Limited/F/U

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$20.57 / $22.85 / $41.15
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.07 / $82.34 / $330.97
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$18.01 / $22.86 / $94.81
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$20.23 / $41.58 / $93.23
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.61 / $46.67 / $47.70
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$17.48 / $19.67 / $24.23
Ambetter
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$24.09 / $24.09 / $24.09
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.16 / $59.47 / $87.30
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$17.85 / $18.39 / $32.59
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$26.67 / $32.70 / $62.87
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.71 / $30.84 / $59.24
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$26.65 / $26.65 / $26.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.57 / $88.54 / $168.90
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$18.76 / $29.42 / $50.19
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$23.07 / $62.88 / $132.11
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.66 / $32.34 / $57.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.04 / $77.97 / $101.29
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$17.39 / $22.67 / $34.75
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$19.57 / $38.04 / $77.31