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Wisconsin rates for HCPCS 72114

Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views

Facilitymedian $45 · 10th–90th $22$1820%10%10th90th$45Professionalmedian $62 · 10th–90th $16$1860%5%10th90th$62$10.0$20.0$50.0$100.0$200.0$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
26
Typical Low / Median / Typical High
$21.88 / $30.90 / $181.97
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $91.20 / $239.88
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$12.59 / $22.91 / $52.48
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$37.15 / $57.54 / $112.20
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $93.33 / $323.59
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$14.13 / $23.99 / $77.62
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$45.71 / $70.79 / $239.88
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.62 / $56.23 / $74.13
Cigna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$38.02 / $44.67 / $70.79
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $165.96 / $251.19
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$19.05 / $38.90 / $58.88
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$51.29 / $128.82 / $190.55
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $134.90 / $181.97
DeanCare
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$26.92 / $32.36 / $43.65
DeanCare
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$85.11 / $102.33 / $138.04
Medica
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $120.23 / $398.11
Medica
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$16.98 / $33.88 / $151.36
Medica
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$45.71 / $87.10 / $309.03
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $85.11
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $134.90 / $204.17
Network Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$20.42 / $36.31 / $58.88
Network Health
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$61.66 / $97.72 / $147.91
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $154.88 / $269.15
Quartz
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$100.00 / $125.89 / $125.89
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $288.40 / $398.11
Quartz
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$20.89 / $75.86 / $151.36
Quartz
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$67.61 / $208.93 / $309.03
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $162.18 / $162.18
Security Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$38.02 / $38.02 / $38.02
Security Health
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$123.03 / $123.03 / $123.03
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $331.13 / $380.19
Security Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$36.31 / $45.71 / $89.13
Security Health
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$97.72 / $102.33 / $269.15
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $181.97 / $446.68
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$28.18 / $95.50 / $112.20
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$45.71 / $74.13 / $158.49