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North Dakota rates for HCPCS 91110

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$130.41 / $130.41 / $130.41
Aetna
Facility/Professional
Facility
Modifier
53
Low / Median / High Price
$175.53 / $175.53 / $175.53
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$695.73 / $877.64 / $1,191.97
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$106.87 / $173.18 / $269.43
Aetna
Facility/Professional
Professional
Modifier
52
Low / Median / High Price
$335.54 / $422.27 / $505.27
Aetna
Facility/Professional
Professional
Modifier
53
Low / Median / High Price
$134.22 / $168.91 / $202.11
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$588.86 / $747.23 / $1,175.16
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,373.57 / $1,695.08 / $1,815.36
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$216.98 / $267.77 / $279.88
BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$1,156.58 / $1,427.31 / $1,541.81
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$126.71 / $126.71 / $126.71
Cigna
Facility/Professional
Facility
Modifier
53
Low / Median / High Price
$163.30 / $163.30 / $163.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$865.44 / $1,391.96 / $2,246.88
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$135.43 / $232.93 / $369.82
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$699.89 / $1,176.77 / $1,899.83
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$967.45 / $1,842.16 / $5,332.25
Medica
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$156.60 / $291.14 / $1,044.83
Medica
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$796.59 / $1,485.51 / $4,416.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$879.50 / $1,735.40 / $2,104.75
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$170.56 / $279.08 / $442.56
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$747.41 / $1,407.33 / $1,795.02