go back

South Dakota rates for HCPCS 72133

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

Facilitymedian $62 · 10th–90th $62$620%50%$62Professionalmedian $182 · 10th–90th $65$4570%5%10th90th$182$50.0$100.0$200.0$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$43.65 / $61.66 / $61.66
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $213.80 / $363.08
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$52.48 / $61.66 / $112.20
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$131.83 / $154.88 / $199.53
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $478.63 / $602.56
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$112.20 / $138.04 / $173.78
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$275.42 / $338.84 / $426.58
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $416.87 / $2,290.87
Medica
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$63.10 / $102.33 / $524.81
Medica
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$199.53 / $309.03 / $2,398.83
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $426.58 / $588.84
Midlands
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$120.23 / $125.89 / $147.91
Midlands
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$275.42 / $302.00 / $436.52
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $467.74 / $467.74
Midlands
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$131.83 / $131.83 / $131.83
Midlands
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$338.84 / $338.84 / $338.84
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $389.05 / $537.03
Sanford Health Plan
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$74.13 / $97.72 / $114.82
Sanford Health Plan
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$190.55 / $275.42 / $457.09
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $426.58 / $588.84
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$64.57 / $107.15 / $158.49
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$173.78 / $309.03 / $457.09
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $457.09 / $457.09
Wellmark
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$114.82 / $134.90 / $134.90
Wellmark
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$269.15 / $316.23 / $316.23