go back

Idaho rates for HCPCS 91110

Gi Trc Img Intraluminal Esophagus-Ileum W/I&R

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$902.62 / $1,037.99 / $1,621.76
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$158.08 / $187.33 / $550.84
Aetna
Facility/Professional
Professional
Modifier
52
Low / Median / High Price
$402.07 / $519.00 / $609.69
Aetna
Facility/Professional
Professional
Modifier
53
Low / Median / High Price
$160.83 / $207.60 / $243.88
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$747.63 / $843.98 / $1,057.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$942.89 / $1,257.18 / $1,571.48
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$146.22 / $207.15 / $254.07
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$796.66 / $1,053.00 / $1,327.77
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,231.50 / $2,231.50 / $2,360.80
Hally Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$405.99 / $405.99 / $508.56
Hally Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$1,722.94 / $1,722.94 / $1,954.81
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,114.94 / $1,197.57 / $1,351.44
Moda Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$176.12 / $202.81 / $236.96
Moda Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$938.80 / $1,015.58 / $1,137.94
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $200.30 / $1,083.61
Regence BlueShield
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$1,570.62 / $1,570.62 / $1,570.62
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$893.16 / $1,023.83 / $1,197.56
Regence BlueShield
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$131.13 / $154.28 / $187.02
Regence BlueShield
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$766.00 / $869.55 / $1,010.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$879.50 / $1,267.24 / $1,740.06
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$132.09 / $212.39 / $344.41
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$747.41 / $1,008.92 / $1,408.27