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Minnesota rates for HCPCS 76857

Us Pelvic Nonobstetric Image Dcmtn Limited/F/U

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$24.08 / $24.08 / $24.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.06 / $82.34 / $344.25
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$17.48 / $24.12 / $94.81
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$20.30 / $28.53 / $89.00
BCBS
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$19.57 / $19.57 / $19.57
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.22 / $129.88 / $173.62
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$40.77 / $60.55 / $80.94
BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$49.33 / $74.56 / $92.67
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$52.04 / $81.22 / $195.39
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$76.13 / $96.68 / $161.83
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$26.51 / $44.47 / $72.90
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$41.11 / $52.21 / $96.08
Health Partners
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$45.10 / $74.12 / $153.85
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$76.13 / $76.13 / $153.68
Health Partners
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$35.02 / $35.02 / $65.90
Health Partners
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$41.11 / $41.11 / $79.79
Medica
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$115.00 / $115.00 / $115.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.33 / $113.55 / $385.44
Medica
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$25.26 / $49.49 / $232.81
Medica
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$26.21 / $48.00 / $398.91
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.57 / $90.10 / $172.80
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$25.26 / $44.77 / $79.70
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$26.21 / $45.28 / $86.40