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Wisconsin rates for HCPCS 72120

Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views

Facilitymedian $28 · 10th–90th $16$1000%10%20%10th90th$28Professionalmedian $42 · 10th–90th $11$1510%5%10th90th$42$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
$15.85 / $22.39 / $27.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $60.26 / $204.17
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$8.91 / $17.78 / $42.66
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$23.99 / $38.02 / $70.79
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $61.66 / $208.93
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$10.47 / $16.60 / $58.88
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$28.84 / $44.67 / $154.88
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.49 / $35.48 / $50.12
Cigna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$28.18 / $32.36 / $52.48
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $109.65 / $165.96
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$12.30 / $28.18 / $43.65
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$33.88 / $81.28 / $120.23
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $89.13 / $123.03
DeanCare
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$19.95 / $23.99 / $32.36
DeanCare
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$54.95 / $66.07 / $91.20
Medica
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$100.00 / $100.00 / $338.84
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $81.28 / $263.03
Medica
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$11.75 / $23.99 / $117.49
Medica
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$30.90 / $61.66 / $199.53
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $70.79
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $87.10 / $162.18
Network Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$14.45 / $25.12 / $40.74
Network Health
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$39.81 / $63.10 / $117.49
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $107.15 / $177.83
Quartz
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $190.55 / $263.03
Quartz
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$15.49 / $56.23 / $117.49
Quartz
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$42.66 / $134.90 / $208.93
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $104.71 / $104.71
Security Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$28.18 / $28.18 / $28.18
Security Health
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$77.62 / $77.62 / $77.62
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $218.78 / $257.04
Security Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$24.55 / $31.62 / $64.57
Security Health
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$61.66 / $75.86 / $173.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $138.04 / $302.00
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$19.95 / $70.79 / $95.50
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$53.70 / $95.50 / $213.80