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Pennsylvania rates for HCPCS 72126

Computed tomography, cervical spine; with contrast material

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$58.20 / $76.48 / $164.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$160.91 / $215.66 / $520.83
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$51.41 / $61.24 / $164.64
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$106.66 / $141.41 / $299.24
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$43.54 / $52.83 / $89.67
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$166.10 / $172.37 / $172.37
Capital Blue Cross
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$57.40 / $59.57 / $114.02
Capital Blue Cross
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$108.70 / $112.80 / $300.42
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
$156.69 / $316.20 / $556.34
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$41.89 / $70.23 / $114.76
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$109.57 / $218.34 / $433.55
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.68 / $264.58 / $805.59
Emblem Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$62.76 / $75.43 / $119.13
Emblem Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$130.12 / $161.94 / $230.65
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.07 / $225.07 / $225.07
Highmark BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$64.14 / $70.56 / $107.66
Martin's Point
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$58.20 / $81.76 / $202.34
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$164.38 / $233.33 / $585.72
Martin's Point
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$54.26 / $73.45 / $164.64
Martin's Point
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$108.96 / $145.62 / $414.94
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.98 / $174.33 / $347.74
Priority Health
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$39.86 / $65.98 / $65.98
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$163.36 / $306.73 / $543.69
Priority Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$43.62 / $69.69 / $117.89
Priority Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$109.57 / $216.03 / $416.15
UPMC Health Plan
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$57.10 / $57.10 / $65.50
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.99 / $168.37 / $337.32
UPMC Health Plan
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$55.65 / $57.10 / $65.50
UPMC Health Plan
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$108.89 / $111.27 / $271.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.94 / $262.29 / $436.95
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$54.15 / $67.45 / $114.85
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$112.81 / $158.09 / $305.62