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Michigan rates for HCPCS 72157

Mri Spinal Canal Thoracic W/O & W/Contr Matrl

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$139.87 / $139.87 / $146.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$336.44 / $475.00 / $661.50
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$110.41 / $140.00 / $475.27
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$222.88 / $335.00 / $433.00
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.00 / $314.62 / $316.33
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$84.38 / $108.19 / $155.19
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$161.85 / $389.02 / $656.14
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$116.00 / $249.54 / $415.37
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$124.22 / $124.22 / $124.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$345.71 / $686.76 / $1,207.27
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$85.10 / $141.90 / $270.72
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$228.32 / $433.12 / $1,067.46
Health Alliance Plan
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$100.86 / $139.87 / $142.38
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.07 / $482.40 / $644.54
Health Alliance Plan
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$100.86 / $140.00 / $462.64
Health Alliance Plan
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$250.93 / $343.34 / $485.75
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.51 / $198.34 / $337.76
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$352.25 / $597.09 / $1,075.90
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$107.04 / $129.02 / $189.51
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$232.53 / $305.73 / $808.92