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Missouri rates for HCPCS 72126

Computed tomography, cervical spine; with contrast material

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$66.27 / $73.54 / $132.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$178.24 / $275.00 / $971.02
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$55.00 / $67.38 / $240.59
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$116.67 / $186.91 / $786.52
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$42.58 / $59.82 / $85.70
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$205.45 / $262.02 / $594.97
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$60.47 / $77.16 / $126.39
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$144.97 / $185.59 / $482.45
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$65.98 / $65.98 / $65.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$146.80 / $295.20 / $535.50
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$50.26 / $82.25 / $143.99
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$99.58 / $204.09 / $418.90
Medica
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$417.20 / $540.32 / $540.32
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$198.49 / $346.54 / $1,882.38
Medica
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$60.26 / $82.64 / $434.24
Medica
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$136.05 / $268.45 / $1,576.92
Qualchoice
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$104.52 / $104.52 / $104.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$189.52 / $274.20 / $486.56
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$57.49 / $72.81 / $144.93
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$130.49 / $196.74 / $325.48