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Utah rates for HCPCS 72133

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

Facilitymedian $71 · 10th–90th $71$710%50%$71Professionalmedian $186 · 10th–90th $62$4070%5%10th90th$186$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
$70.79 / $70.79 / $70.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $257.04 / $457.09
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$54.95 / $64.57 / $134.90
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$141.25 / $190.55 / $338.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $363.08 / $562.34
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$53.70 / $74.13 / $125.89
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$134.90 / $263.03 / $446.68
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $446.68
Regence BlueShield
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$323.59 / $323.59 / $323.59
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $338.84 / $602.56
Regence BlueShield
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$83.18 / $97.72 / $141.25
Regence BlueShield
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$199.53 / $239.88 / $457.09
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $302.00 / $467.74
Select Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$57.54 / $123.03 / $147.91
Select Health
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$128.82 / $177.83 / $275.42
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $218.78 / $380.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $302.00 / $512.86
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$51.29 / $54.95 / $107.15
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$144.54 / $218.78 / $436.52