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North Carolina rates for HCPCS 76857

Us Pelvic Nonobstetric Image Dcmtn Limited/F/U

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$21.00 / $24.92 / $35.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.06 / $82.34 / $278.97
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$18.01 / $27.02 / $76.08
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$20.74 / $46.09 / $70.76
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.67 / $64.23 / $80.27
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$17.48 / $25.32 / $47.04
Ambetter
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$28.45 / $28.45 / $28.45
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.92 / $47.92 / $47.92
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$27.31 / $41.56 / $67.94
BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$62.46 / $96.82 / $150.52
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
$50.57 / $95.84 / $162.27
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$19.13 / $33.07 / $61.93
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$24.67 / $59.53 / $127.99
Medcost
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$28.19 / $32.00 / $57.51
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.00 / $61.00 / $172.00
Medcost
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$28.19 / $28.19 / $32.00
Medcost
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$86.15 / $86.15 / $86.15
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.73 / $41.87 / $84.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.06 / $82.36 / $140.16
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$18.38 / $29.07 / $54.92
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$22.43 / $50.02 / $85.54
Wellcare
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$55.69 / $115.19 / $115.19
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$592.92 / $592.92 / $592.92
Wellcare
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$232.81 / $232.81 / $232.81
Wellcare
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$385.57 / $409.84 / $409.84