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Pennsylvania rates for HCPCS D0367

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

Facilitymedian $141 · 10th–90th $141–$1410%50%$141Professionalmedian $174 · 10th–90th $123–$2240%10%10th90th$174$1.0$5.0$20.0$100.0$500.0

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $141.25 / $141.25
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $173.78 / $223.87
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $141.25 / $141.25
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $169.82 / $223.87
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $323.59