go back

Tennessee 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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$164.21 / $173.28 / $556.39
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$411.07 / $519.00 / $924.51
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$108.70 / $164.09 / $303.35
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$271.19 / $347.56 / $519.45
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$174.00 / $313.75 / $696.00
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$80.33 / $125.53 / $250.45
Ambetter
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$74.87 / $74.87 / $280.76
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$285.62 / $607.99 / $1,063.77
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$104.40 / $166.19 / $266.41
BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$218.31 / $463.80 / $880.96
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$111.95 / $111.95 / $124.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$282.07 / $669.16 / $1,421.39
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$94.37 / $162.71 / $254.49
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$189.61 / $461.82 / $1,167.91
Lucent Health
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$996.56 / $996.56 / $1,016.96
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,146.58 / $6,330.97 / $6,330.97
Lucent Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$921.60 / $921.60 / $921.60
Lucent Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$5,551.18 / $5,717.71 / $5,717.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$341.10 / $596.50 / $1,132.79
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$109.42 / $134.62 / $235.38
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$228.92 / $379.50 / $905.58