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Maine rates for HCPCS 72147

Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; with contrast material(s)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$165.96 / $165.96 / $165.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.00 / $457.09 / $1,071.52
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$87.10 / $125.89 / $281.84
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $398.11 / $1,023.29
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$81.28 / $120.23 / $275.42
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.54 / $630.96 / $1,047.13
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$85.11 / $125.89 / $239.88
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$316.23 / $416.87 / $776.25
Harvard Pilgrim
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$100.00 / $125.89 / $234.42
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.74 / $588.84 / $1,122.02
Martin's Point
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$100.00 / $158.49 / $281.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$295.12 / $446.68 / $912.01
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$87.10 / $125.89 / $229.09