go back

Missouri rates for HCPCS 77014

Computed tomography guidance for placement of radiation therapy fields

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$60.55 / $81.16 / $99.62
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.54 / $709.48 / $709.48
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$76.86 / $257.12 / $257.12
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$127.68 / $452.37 / $452.37
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.01 / $129.43 / $177.99
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$34.60 / $52.26 / $67.86
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.49 / $136.00 / $323.23
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$43.88 / $53.03 / $86.84
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$66.59 / $84.38 / $245.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$185.04 / $185.04 / $185.04
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$68.69 / $68.69 / $68.69
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$116.35 / $116.35 / $116.35
Medica
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$331.68 / $420.16 / $420.16
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$121.51 / $173.43 / $968.53
Medica
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$42.16 / $54.74 / $279.39
Medica
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$75.81 / $119.63 / $774.95
Qualchoice
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.69 / $204.69 / $204.69
Qualchoice
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$82.04 / $82.04 / $82.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.79 / $154.77 / $283.52
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$42.56 / $52.02 / $103.35
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$74.40 / $95.67 / $185.54