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Indiana rates for HCPCS 72126

Computed tomography, cervical spine; with contrast material

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$67.61 / $74.13 / $102.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.82 / $218.78 / $426.58
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$53.70 / $77.62 / $186.21
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$109.65 / $147.91 / $302.00
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$42.66 / $47.86 / $79.43
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.88 / $302.00 / $467.74
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$63.10 / $79.43 / $123.03
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$169.82 / $223.87 / $354.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.96 / $323.59 / $616.60
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$51.29 / $77.62 / $138.04
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$112.20 / $239.88 / $467.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.97 / $275.42 / $457.09
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$52.48 / $64.57 / $109.65
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$123.03 / $199.53 / $363.08