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South Dakota rates for HCPCS 72191

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

Facilitymedian $85 · 10th–90th $63$850%50%10th$85Professionalmedian $245 · 10th–90th $85$6170%5%10th90th$245$50.0$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$63.10 / $85.11 / $85.11
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $316.23 / $616.60
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$74.13 / $89.13 / $158.49
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$162.18 / $218.78 / $512.86
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $741.31 / $933.25
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$158.49 / $194.98 / $245.47
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$436.52 / $549.54 / $676.08
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $489.78 / $3,090.30
Medica
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$91.20 / $144.54 / $549.54
Medica
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$218.78 / $371.54 / $2,630.27
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $575.44 / $645.65
Midlands
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$169.82 / $181.97 / $208.93
Midlands
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$346.74 / $389.05 / $436.52
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $549.54 / $549.54
Midlands
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
Midlands
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$371.54 / $371.54 / $371.54
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $512.86 / $616.60
Sanford Health Plan
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$104.71 / $141.25 / $162.18
Sanford Health Plan
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$269.15 / $371.54 / $501.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $588.84 / $776.25
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$91.20 / $154.88 / $223.87
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$245.47 / $436.52 / $549.54
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $707.95 / $707.95
Wellmark
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$162.18 / $190.55 / $190.55
Wellmark
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$436.52 / $512.86 / $512.86