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Massachusetts rates for HCPCS 72158

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$152.12 / $152.13 / $316.97
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$330.58 / $532.64 / $1,830.98
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$111.15 / $152.13 / $356.93
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$217.27 / $335.00 / $828.02
AllWays Health Partners
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$254.53 / $794.00 / $996.56
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$379.15 / $790.53 / $6,330.97
AllWays Health Partners
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$99.55 / $164.21 / $921.60
AllWays Health Partners
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$263.87 / $562.14 / $5,717.71
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$124.03 / $207.33 / $316.92
BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$856.55 / $856.55 / $1,148.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$379.15 / $756.65 / $1,598.16
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$108.68 / $167.71 / $329.56
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$274.04 / $567.85 / $1,248.83
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$139.32 / $327.79 / $608.58
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.13 / $801.83 / $1,041.15
Harvard Pilgrim
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$133.12 / $265.49 / $348.12
Harvard Pilgrim
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$265.01 / $528.54 / $693.03
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$156.81 / $216.27 / $336.71
Mass General Brigham
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$794.00 / $996.56 / $996.56
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$388.73 / $985.80 / $6,330.97
Mass General Brigham
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$109.31 / $175.05 / $921.60
Mass General Brigham
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$264.60 / $645.46 / $5,717.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$372.81 / $726.60 / $1,389.05
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$106.28 / $146.69 / $280.31
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$255.52 / $383.28 / $1,049.88