go back

Indiana 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
$61.66 / $83.18 / $107.15
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $251.19 / $436.52
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$53.70 / $64.57 / $109.65
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$134.90 / $173.78 / $323.59
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.83 / $131.83 / $131.83
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$44.67 / $45.71 / $63.10
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.04 / $346.74 / $537.03
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$64.57 / $83.18 / $128.82
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$190.55 / $263.03 / $407.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.98 / $380.19 / $741.31
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$52.48 / $81.28 / $144.54
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$138.04 / $288.40 / $575.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.80 / $323.59 / $549.54
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$53.70 / $66.07 / $114.82
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$151.36 / $251.19 / $457.09