go back

Washington rates for HCPCS 72133

Ct Lumbar Spine W/O & W/Contrast Material

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$67.33 / $133.76 / $218.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$216.07 / $342.37 / $466.06
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$54.56 / $67.33 / $134.56
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$154.59 / $270.52 / $346.70
Asuris Northwest Health
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$561.91 / $561.91 / $561.91
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$285.05 / $492.45 / $2,293.84
Asuris Northwest Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$83.16 / $141.79 / $523.40
Asuris Northwest Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$201.89 / $364.63 / $2,412.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$221.84 / $470.01 / $729.65
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$59.50 / $108.86 / $189.01
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$160.38 / $347.57 / $574.41
Kaiser Permanente
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$66.64 / $136.21 / $539.79
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$267.83 / $537.65 / $931.09
Kaiser Permanente
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$59.21 / $127.46 / $165.21
Kaiser Permanente
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$221.76 / $413.36 / $771.24
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.65 / $201.84 / $457.79
Pacific Source
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$97.83 / $117.40 / $121.27
Pacific Source
Facility/Professional
Professional
Modifier
Low / Median / High Price
$270.14 / $270.14 / $270.14
Pacific Source
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$72.36 / $102.03 / $127.61
Pacific Source
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$230.67 / $333.21 / $462.50
Premera BCBS
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$81.34 / $81.34 / $81.54
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$317.55 / $479.53 / $586.87
Premera BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$92.47 / $138.93 / $166.84
Premera BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$224.76 / $339.37 / $421.20
Regence BlueShield
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$346.39 / $346.39 / $851.78
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$285.05 / $421.43 / $625.14
Regence BlueShield
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$83.16 / $123.18 / $166.47
Regence BlueShield
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$201.89 / $298.25 / $448.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$197.86 / $335.40 / $635.33
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$54.91 / $71.09 / $176.90
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$142.94 / $242.32 / $459.55
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$228.16 / $228.16 / $228.16
Wellpoint
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$62.26 / $62.26 / $62.26
Wellpoint
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$165.90 / $165.90 / $165.90