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Delaware rates for HCPCS 72158

Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar

Facilitymedian $126 · 10th–90th $110–$3240%10%20%10th90th$126Professionalmedian $263 · 10th–90th $110–$8130%5%10%10th90th$263$20.0$100.0$500.0$2.0K

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
$109.65 / $125.89 / $323.59
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $501.19 / $1,348.96
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$104.71 / $158.49 / $331.13
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$218.78 / $302.00 / $707.95
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $660.69 / $1,288.25
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$77.62 / $134.90 / $223.87
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$213.80 / $512.86 / $1,122.02
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $323.59 / $380.19
Highmark BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$104.71 / $138.04 / $1,174.90
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $489.78 / $1,659.59
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$79.43 / $128.82 / $549.54
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$208.93 / $575.44 / $1,122.02