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Arizona rates for HCPCS 72133

Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$213.80 / $263.03 / $288.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.97 / $275.42 / $660.69
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$51.29 / $67.61 / $158.49
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$128.82 / $213.80 / $501.19
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.78 / $173.78 / $173.78
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$45.71 / $54.95 / $109.65
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.53 / $257.04 / $457.09
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$52.48 / $67.61 / $117.49
BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$147.91 / $190.55 / $331.13
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$14.45 / $67.61 / $97.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.96 / $316.23 / $602.56
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$46.77 / $70.79 / $128.82
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$120.23 / $229.09 / $467.74
Medica
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$436.52 / $562.34 / $562.34
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.53 / $354.81 / $2,290.87
Medica
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$51.29 / $63.10 / $524.81
Medica
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$144.54 / $302.00 / $2,398.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.53 / $302.00 / $489.78
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$51.29 / $54.95 / $102.33
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$144.54 / $239.88 / $371.54