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Massachusetts rates for HCPCS 76857

Us Pelvic Nonobstetric Image Dcmtn Limited/F/U

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$18.12 / $23.14 / $68.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.61 / $82.84 / $326.60
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$18.01 / $29.10 / $63.89
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$18.48 / $55.11 / $82.38
AllWays Health Partners
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$55.07 / $57.85 / $115.19
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.22 / $100.63 / $592.92
AllWays Health Partners
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$18.32 / $34.57 / $232.81
AllWays Health Partners
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$25.67 / $64.09 / $409.84
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.52 / $22.01 / $29.72
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$33.45 / $44.73 / $59.45
BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$35.18 / $60.30 / $136.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.31 / $96.91 / $190.30
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$20.35 / $35.29 / $69.19
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$28.14 / $56.63 / $110.02
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.04 / $43.23 / $91.45
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.44 / $121.80 / $160.74
Harvard Pilgrim
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$28.67 / $56.14 / $74.94
Harvard Pilgrim
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$32.77 / $64.95 / $85.70
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.74 / $56.28 / $156.74
Mass General Brigham
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$55.69 / $115.19 / $115.19
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.27 / $106.82 / $592.92
Mass General Brigham
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$18.80 / $34.15 / $232.81
Mass General Brigham
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$26.46 / $66.15 / $409.84
Tufts
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.27 / $88.59 / $110.81
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.35 / $76.80 / $144.12
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$17.20 / $31.27 / $69.90
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$25.45 / $42.92 / $92.27