go back

Minnesota rates for HCPCS 72128

Computed tomography, thoracic spine; without contrast material

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$47.86 / $47.86 / $81.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.83 / $218.78 / $630.96
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$43.65 / $64.57 / $190.55
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$83.18 / $120.23 / $309.03
BCBS
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$34.67 / $39.81 / $39.81
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.78 / $323.59 / $467.74
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$75.86 / $112.20 / $165.96
BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$141.25 / $218.78 / $309.03
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$38.02 / $151.36 / $416.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.98 / $257.04 / $512.86
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$53.70 / $89.13 / $144.54
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$131.83 / $165.96 / $346.74
Health Partners
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$134.90 / $165.96 / $323.59
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.17 / $204.17 / $416.87
Health Partners
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$70.79 / $70.79 / $109.65
Health Partners
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$131.83 / $131.83 / $323.59
Medica
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$446.68 / $446.68 / $446.68
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.49 / $338.84 / $1,621.81
Medica
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$56.23 / $109.65 / $467.74
Medica
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$107.15 / $234.42 / $1,318.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.49 / $302.00 / $478.63
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$51.29 / $85.11 / $151.36
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$102.33 / $208.93 / $338.84