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Alabama rates for HCPCS D0367

cone beam CT capture and interpretation with field of view of both jaws; with or without cranium

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$169.30 / $169.30 / $169.30
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.91 / $169.30 / $206.97
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.03 / $97.13 / $130.66
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$161.25 / $161.25 / $161.25