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Michigan rates for HCPCS 72125

Computed tomography, cervical spine; without contrast material

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$60.39 / $60.39 / $76.09
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.44 / $220.81 / $371.00
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$46.15 / $60.40 / $206.19
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$92.02 / $148.06 / $286.22
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.80 / $108.83 / $128.03
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$36.15 / $55.38 / $80.93
Ambetter
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$59.26 / $59.26 / $59.26
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.70 / $152.99 / $223.62
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$74.56 / $74.56 / $74.56
BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$136.35 / $136.35 / $136.35
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.27 / $98.12 / $165.84
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$54.02 / $54.02 / $54.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$159.19 / $277.83 / $446.43
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$38.92 / $65.37 / $119.34
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$105.89 / $173.08 / $312.12
Health Alliance Plan
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$41.49 / $60.39 / $63.42
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.21 / $187.51 / $351.75
Health Alliance Plan
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$41.49 / $60.40 / $188.76
Health Alliance Plan
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$98.70 / $146.02 / $242.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.95 / $108.90 / $159.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$142.26 / $220.45 / $316.32
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$47.78 / $55.92 / $88.65
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$97.78 / $158.02 / $243.83