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New Hampshire rates for HCPCS 72149

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

Facilitymedian $195 · 10th–90th $129$3310%20%40%10th90th$195Professionalmedian $295 · 10th–90th $112$6310%5%10th90th$295$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
$128.82 / $194.98 / $331.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $426.58 / $831.76
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$85.11 / $125.89 / $229.09
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$194.98 / $302.00 / $501.19
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $645.65 / $912.01
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$81.28 / $190.55 / $275.42
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$186.21 / $436.52 / $691.83
Cigna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$107.15 / $107.15 / $107.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $630.96 / $1,380.38
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$93.33 / $158.49 / $257.04
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$245.47 / $446.68 / $1,148.15
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $489.78 / $776.25
Harvard Pilgrim
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$95.50 / $147.91 / $229.09
Harvard Pilgrim
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$218.78 / $338.84 / $537.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $562.34 / $1,000.00
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$91.20 / $134.90 / $269.15
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$223.87 / $363.08 / $676.08
Well Sense
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$63.10 / $69.18 / $83.18