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Pennsylvania rates for HCPCS 70552

Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$114.82 / $245.47 / $467.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$281.84 / $478.63 / $1,778.28
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$85.11 / $141.25 / $309.03
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$190.55 / $331.13 / $691.83
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.97 / $181.97 / $181.97
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$69.18 / $79.43 / $138.04
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $380.19 / $758.58
Capital Blue Cross
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$85.11 / $112.20 / $208.93
Capital Blue Cross
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$181.97 / $269.15 / $851.14
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$20.42 / $95.50 / $138.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$263.03 / $512.86 / $912.01
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$63.10 / $104.71 / $173.78
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$177.83 / $380.19 / $776.25
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$281.84 / $363.08 / $457.09
Emblem Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$83.18 / $109.65 / $131.83
Emblem Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$199.53 / $257.04 / $323.59
Geisinger
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.42 / $426.58 / $812.83
Geisinger
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$72.44 / $100.00 / $181.97
Geisinger
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$190.55 / $338.84 / $602.56
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$316.23 / $316.23 / $616.60
Highmark BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$91.20 / $102.33 / $158.49
Martin's Point
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$117.49 / $223.87 / $426.58
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$295.12 / $478.63 / $1,071.52
Martin's Point
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$85.11 / $141.25 / $275.42
Martin's Point
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$199.53 / $338.84 / $724.44
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.04 / $489.78 / $707.95
UPMC Health Plan
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$83.18 / $97.72 / $97.72
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.49 / $380.19 / $416.87
UPMC Health Plan
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$81.28 / $83.18 / $97.72
UPMC Health Plan
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$181.97 / $186.21 / $512.86
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$263.03 / $389.05 / $724.44
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$72.44 / $91.20 / $162.18
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$186.21 / $269.15 / $575.44