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Montana rates for HCPCS 72191

Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing

Facilitymedian $132 · 10th–90th $132$1620%20%40%90th$132Professionalmedian $275 · 10th–90th $89$6310%5%10th90th$275$50.0$100.0$200.0$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $467.74 / $1,023.29
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$81.28 / $151.36 / $323.59
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$181.97 / $309.03 / $562.34
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $131.83 / $691.83
Cigna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$131.83 / $131.83 / $162.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $501.19 / $851.14
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$58.88 / $131.83 / $234.42
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$239.88 / $363.08 / $645.65
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $537.03 / $776.25
Providence
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$131.83 / $131.83 / $162.18
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $691.83 / $851.14
Providence
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$89.13 / $131.83 / $194.98
Providence
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$245.47 / $363.08 / $537.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $416.87 / $660.69
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$75.86 / $79.43 / $162.18
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$186.21 / $316.23 / $489.78