go back

South Carolina rates for HCPCS 72133

Ct Lumbar Spine W/O & W/Contrast Material

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$83.00 / $83.00 / $83.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$197.33 / $275.00 / $342.37
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$53.83 / $60.67 / $83.00
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$140.27 / $192.00 / $287.81
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$27.98 / $55.96 / $60.16
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$180.22 / $477.00 / $792.50
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$55.96 / $84.00 / $194.25
BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$124.27 / $187.00 / $495.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$246.88 / $381.33 / $675.00
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$58.33 / $85.00 / $155.19
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$175.30 / $315.45 / $543.29
Medcost
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$91.04 / $107.00 / $185.58
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$145.72 / $145.72 / $739.42
Medcost
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$223.27 / $223.27 / $223.27
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.14 / $161.11 / $253.05
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.97 / $346.94 / $596.94
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$58.14 / $77.52 / $129.12
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$155.43 / $260.67 / $494.89