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New Hampshire rates for HCPCS 72191

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

Facilitymedian $331 · 10th–90th $83$3310%50%10th$331Professionalmedian $275 · 10th–90th $91$6460%5%10th90th$275$100.0$200.0$500.0$1.0K$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
$331.13 / $331.13 / $331.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $346.74 / $562.34
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$70.79 / $91.20 / $190.55
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$169.82 / $223.87 / $380.19
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $707.95 / $1,023.29
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$83.18 / $190.55 / $275.42
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$177.83 / $512.86 / $741.31
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $676.08 / $1,174.90
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$95.50 / $141.25 / $251.19
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$257.04 / $489.78 / $954.99
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $562.34 / $831.76
Harvard Pilgrim
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$95.50 / $147.91 / $218.78
Harvard Pilgrim
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$257.04 / $398.11 / $588.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $549.54 / $1,000.00
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$91.20 / $128.82 / $251.19
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$257.04 / $398.11 / $707.95
Well Sense
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$63.10 / $69.18 / $83.18