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Wisconsin rates for HCPCS 72133

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

Facilitymedian $138 · 10th–90th $117$5500%20%10th90th$138Professionalmedian $214 · 10th–90th $62$6030%5%10%10th90th$214$50.0$100.0$200.0$500.0$1.0K$2.0K$5.0K

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$117.49 / $117.49 / $125.89
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $275.42 / $436.52
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$57.54 / $72.44 / $158.49
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$138.04 / $190.55 / $323.59
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $389.05 / $1,174.90
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$58.88 / $93.33 / $338.84
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$141.25 / $281.84 / $812.83
Cigna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$158.49 / $181.97 / $295.12
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $575.44 / $831.76
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$66.07 / $141.25 / $245.47
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$190.55 / $398.11 / $588.84
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $436.52 / $676.08
DeanCare
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$109.65 / $131.83 / $177.83
DeanCare
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$257.04 / $309.03 / $524.81
Medica
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$562.34 / $562.34 / $562.34
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $537.03 / $2,290.87
Medica
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$64.57 / $128.82 / $524.81
Medica
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$190.55 / $416.87 / $2,398.83
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $389.05
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $562.34 / $870.96
Network Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$83.18 / $141.25 / $229.09
Network Health
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$213.80 / $457.09 / $691.83
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $501.19 / $1,148.15
Quartz
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$138.04 / $549.54 / $549.54
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $1,318.26 / $2,344.23
Quartz
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$87.10 / $309.03 / $524.81
Quartz
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$213.80 / $1,122.02 / $2,398.83
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $537.03 / $537.03
Security Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$158.49 / $158.49 / $158.49
Security Health
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$380.19 / $380.19 / $380.19
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $1,174.90 / $1,698.24
Security Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$204.17 / $218.78 / $338.84
Security Health
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$501.19 / $707.95 / $977.24
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $457.09 / $851.14
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$64.57 / $114.82 / $257.04
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$169.82 / $346.74 / $707.95