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Tennessee rates for HCPCS 72191

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$102.33 / $436.52 / $489.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.88 / $316.23 / $549.54
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$54.95 / $91.20 / $204.17
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$158.49 / $218.78 / $389.05
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $269.15 / $269.15
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$169.82 / $169.82 / $169.82
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.42 / $346.74 / $741.31
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$85.11 / $138.04 / $218.78
BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$204.17 / $389.05 / $616.60
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$87.10 / $87.10 / $87.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.42 / $457.09 / $831.76
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$74.13 / $117.49 / $199.53
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$194.98 / $354.81 / $645.65
Lucent Health
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$776.25 / $776.25 / $776.25
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,162.28 / $3,162.28 / $3,162.28
Lucent Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$549.54 / $676.08 / $676.08
Lucent Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$2,691.53 / $2,691.53 / $2,691.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$295.12 / $446.68 / $676.08
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$83.18 / $102.33 / $177.83
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$213.80 / $323.59 / $512.86