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Ohio rates for HCPCS 72191

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

Facilitymedian $115 · 10th–90th $85$2950%20%10th90th$115Professionalmedian $229 · 10th–90th $85$5130%10%10th90th$229$1.0$5.0$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
$85.11 / $114.82 / $295.12
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $316.23 / $741.31
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$70.79 / $95.50 / $213.80
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$162.18 / $218.78 / $537.03
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $190.55 / $190.55
Ambetter
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$79.43 / $79.43 / $85.11
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $346.74 / $588.84
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$64.57 / $97.72 / $177.83
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$190.55 / $245.47 / $407.38
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $446.68 / $851.14
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$74.13 / $112.20 / $199.53
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$204.17 / $331.13 / $676.08
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$20.89 / $97.72 / $138.04
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $436.52 / $851.14
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$74.13 / $109.65 / $190.55
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$199.53 / $309.03 / $645.65
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $204.17
SummaCare
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$213.80 / $213.80 / $213.80
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $234.42 / $426.58
SummaCare
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$81.28 / $102.33 / $177.83
SummaCare
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$107.15 / $134.90 / $263.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $371.54 / $660.69
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$70.79 / $95.50 / $169.82
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$186.21 / $269.15 / $524.81