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Oregon rates for HCPCS 76857

Us Pelvic Nonobstetric Image Dcmtn Limited/F/U

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$32.10 / $50.40 / $116.62
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.00 / $88.24 / $340.90
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$16.92 / $32.11 / $95.56
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$24.93 / $63.43 / $104.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.14 / $108.36 / $171.66
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$22.44 / $47.06 / $68.33
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$30.97 / $60.62 / $108.83
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.91 / $111.78 / $134.12
Kaiser Permanente
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$44.20 / $52.29 / $60.36
Kaiser Permanente
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$51.04 / $59.72 / $73.76
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.65 / $114.02 / $159.15
Moda Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$34.97 / $44.62 / $74.26
Moda Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$42.70 / $56.42 / $84.89
Pacific Source
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$33.14 / $45.07 / $46.92
Pacific Source
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.00 / $35.67 / $60.54
Pacific Source
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$26.10 / $36.18 / $52.54
Pacific Source
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$33.00 / $48.41 / $122.43
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.57 / $110.10 / $150.38
Providence
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$26.92 / $48.83 / $68.33
Providence
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$33.07 / $60.12 / $108.83
Regence BlueShield
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$385.75 / $385.75 / $385.75
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.38 / $116.31 / $138.34
Regence BlueShield
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$41.90 / $55.39 / $66.33
Regence BlueShield
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$45.49 / $61.62 / $72.01
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.79 / $59.90 / $153.90
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$21.28 / $25.96 / $77.70
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$23.00 / $38.61 / $83.30