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New Jersey 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
$51.59 / $51.59 / $257.97
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$187.69 / $281.58 / $485.55
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$51.59 / $60.63 / $87.88
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$132.03 / $216.06 / $372.60
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$44.25 / $46.09 / $122.66
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$41.83 / $41.83 / $41.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$188.89 / $405.11 / $667.41
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$43.17 / $75.06 / $126.68
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$143.99 / $326.20 / $541.82
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$233.48 / $309.80 / $988.40
Emblem Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$67.14 / $78.45 / $107.13
Emblem Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$165.79 / $199.39 / $270.39
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$191.06 / $224.78 / $453.17
Horizon BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$50.33 / $59.21 / $94.17
Horizon BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$140.72 / $165.57 / $287.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$188.18 / $306.23 / $523.10
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$47.46 / $71.06 / $113.46
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$117.21 / $203.27 / $387.92