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Wyoming rates for HCPCS 72128

Computed tomography, thoracic spine; without contrast material

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$45.08 / $45.08 / $45.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.35 / $172.01 / $280.77
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$44.14 / $49.32 / $115.98
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$78.86 / $113.74 / $231.46
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$344.00 / $564.00 / $564.00
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$120.00 / $196.00 / $196.00
BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$224.00 / $368.00 / $368.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$211.67 / $280.16 / $505.89
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$63.17 / $75.86 / $130.31
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$137.80 / $193.64 / $373.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$214.86 / $305.07 / $768.90
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$43.32 / $90.00 / $164.99
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$158.84 / $206.16 / $589.60