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Oklahoma rates for HCPCS 91200

Liver Elastography W/O Imag W/I&R

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$9.86 / $9.86 / $19.55
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.97 / $31.66 / $45.01
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$10.06 / $10.77 / $16.18
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$17.89 / $20.89 / $28.82
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.85 / $29.75 / $40.85
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$22.13 / $22.13 / $22.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.22 / $46.81 / $53.21
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$11.19 / $18.05 / $22.92
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$20.03 / $26.55 / $31.40
Medica
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$24.22 / $70.00 / $70.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.21 / $39.78 / $195.66
Medica
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$12.56 / $17.32 / $69.84
Medica
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$19.93 / $26.96 / $129.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.21 / $39.78 / $72.48
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$12.28 / $15.88 / $27.62
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$19.87 / $24.62 / $43.64