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Swallowed Capsule Camera Bowel Exam

Maine rates for HCPCS 91110

This test uses a small swallowable capsule containing a camera that takes pictures as it travels through the esophagus, stomach, and small intestine. The images are transmitted to a recorder worn by the patient and later reviewed by a doctor to look for sources of bleeding, inflammation, or other abnormalities in areas that are hard to reach with a standard scope.

Facilitymedian $135 · 10th–90th $135$1350%50%100%$135Professionalmedian $741 · 10th–90th $135$1,6600%5%10%10th90th$741$100.0$500.0$2.0K$10.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
26 · Professional part
Typical Low
$134.90
Median
$134.90
Typical High
$134.90
Aetna
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$954.99
Typical High
$2,089.30
Aetna
Setting
Professional
Modifier
26 · Professional part
Typical Low
$109.65
Median
$162.18
Typical High
$407.38
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$275.42
Median
$891.25
Typical High
$1,071.52
Aetna
Setting
Professional
Modifier
TC · Technical part
Typical Low
$616.60
Median
$758.58
Typical High
$1,412.54
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$776.25
Median
$933.25
Typical High
$1,698.24
Anthem BCBS
Setting
Professional
Modifier
26 · Professional part
Typical Low
$104.71
Median
$147.91
Typical High
$251.19
Anthem BCBS
Setting
Professional
Modifier
TC · Technical part
Typical Low
$660.69
Median
$794.33
Typical High
$1,445.44
Cigna
Setting
Professional
Modifier
Global
Typical Low
$891.25
Median
$1,071.52
Typical High
$2,041.74
Cigna
Setting
Professional
Modifier
26 · Professional part
Typical Low
$131.83
Median
$213.80
Typical High
$323.59
Cigna
Setting
Professional
Modifier
TC · Technical part
Typical Low
$724.44
Median
$891.25
Typical High
$1,698.24
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$977.24
Median
$1,230.27
Typical High
$2,290.87
Harvard Pilgrim
Setting
Professional
Modifier
26 · Professional part
Typical Low
$141.25
Median
$181.97
Typical High
$338.84
Harvard Pilgrim
Setting
Professional
Modifier
TC · Technical part
Typical Low
$831.76
Median
$1,047.13
Typical High
$1,949.84
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$758.58
Median
$954.99
Typical High
$1,862.09
Martin's Point
Setting
Professional
Modifier
26 · Professional part
Typical Low
$120.23
Median
$165.96
Typical High
$346.74
Martin's Point
Setting
Professional
Modifier
TC · Technical part
Typical Low
$616.60
Median
$794.33
Typical High
$1,584.89
United
Setting
Professional
Modifier
Global
Typical Low
$851.14
Median
$1,202.26
Typical High
$2,290.87
United
Setting
Professional
Modifier
26 · Professional part
Typical Low
$125.89
Median
$204.17
Typical High
$331.13
United
Setting
Professional
Modifier
TC · Technical part
Typical Low
$691.83
Median
$977.24
Typical High
$1,659.59