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Delaware rates for HCPCS 72128

Computed tomography, thoracic spine; without contrast material

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$47.23 / $61.32 / $124.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$126.00 / $221.75 / $247.93
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$44.14 / $48.62 / $80.03
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$80.56 / $177.61 / $201.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$133.34 / $244.89 / $360.45
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$35.21 / $58.14 / $86.29
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$85.91 / $161.87 / $295.50
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.22 / $131.22 / $131.22
Highmark BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$46.05 / $59.05 / $488.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.68 / $215.54 / $353.87
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$22.59 / $53.92 / $112.02
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$87.25 / $215.61 / $281.44