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New York 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
$70.79 / $91.20 / $194.98
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.21 / $275.42 / $616.60
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$51.29 / $72.44 / $151.36
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$131.83 / $199.53 / $407.38
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.91 / $147.91 / $147.91
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$109.65 / $109.65 / $109.65
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.80 / $269.15 / $676.08
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$51.29 / $64.57 / $128.82
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$165.96 / $204.17 / $524.81
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $213.80 / $302.00
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
$208.93 / $436.52 / $1,737.80
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$46.77 / $87.10 / $245.47
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$151.36 / $346.74 / $1,148.15
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.93 / $269.15 / $398.11
Emblem Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$58.88 / $87.10 / $251.19
Emblem Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$147.91 / $194.98 / $288.40
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.21 / $309.03 / $501.19
Excellus BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$48.98 / $87.10 / $151.36
Excellus BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$128.82 / $229.09 / $354.81
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.47 / $245.47 / $251.19
Highmark BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$70.79 / $72.44 / $123.03
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$263.03 / $316.23 / $575.44
MVP Health Care
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$70.79 / $87.10 / $158.49
MVP Health Care
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$190.55 / $223.87 / $446.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.83 / $275.42 / $575.44
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$48.98 / $64.57 / $138.04
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$128.82 / $194.98 / $446.68
Univera
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$48.98 / $70.79 / $204.17
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.21 / $309.03 / $588.84
Univera
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$48.98 / $87.10 / $173.78
Univera
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$128.82 / $218.78 / $407.38