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Idaho rates for HCPCS 72126

Computed tomography, cervical spine; with contrast material

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$83.27 / $153.36 / $153.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$219.17 / $340.04 / $373.85
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$52.46 / $65.06 / $128.88
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$154.11 / $244.97 / $285.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$142.53 / $159.30 / $416.55
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$48.25 / $53.92 / $109.88
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$94.28 / $105.38 / $311.70
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,057.35 / $1,057.35 / $1,196.61
Hally Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$462.40 / $462.40 / $518.27
Hally Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$539.09 / $539.09 / $734.22
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$273.80 / $315.29 / $411.00
Moda Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$91.26 / $105.09 / $122.79
Moda Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$182.54 / $210.20 / $245.60
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $92.98 / $237.60
Regence BlueShield
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$714.15 / $714.15 / $714.15
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.19 / $355.52 / $411.00
Regence BlueShield
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$99.57 / $117.14 / $141.13
Regence BlueShield
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$202.62 / $238.38 / $269.86
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$168.72 / $249.10 / $539.38
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$50.63 / $62.44 / $124.14
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$115.64 / $198.47 / $413.56