go back

Wisconsin rates for HCPCS 72191

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

Facilitymedian $195 · 10th–90th $162$7760%20%10th90th$195Professionalmedian $275 · 10th–90th $85$7760%5%10th90th$275$50.0$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
$162.18 / $162.18 / $177.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $323.59 / $676.08
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$79.43 / $100.00 / $186.21
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$169.82 / $223.87 / $467.74
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $478.63 / $1,778.28
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$83.18 / $131.83 / $478.63
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$223.87 / $346.74 / $1,318.26
Cigna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$223.87 / $257.04 / $416.87
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $758.58 / $1,258.93
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$93.33 / $199.53 / $346.74
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$251.19 / $616.60 / $933.25
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $676.08 / $933.25
DeanCare
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$154.88 / $186.21 / $251.19
DeanCare
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$416.87 / $489.78 / $630.96
Medica
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$794.33 / $794.33 / $794.33
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $741.31 / $3,090.30
Medica
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$95.50 / $186.21 / $549.54
Medica
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$269.15 / $549.54 / $2,630.27
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $489.78
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $724.44 / $1,096.48
Network Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$117.49 / $199.53 / $323.59
Network Health
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$331.13 / $588.84 / $870.96
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $776.25 / $1,348.96
Quartz
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$194.98 / $776.25 / $776.25
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $1,778.28 / $3,162.28
Quartz
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$109.65 / $436.52 / $549.54
Quartz
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$275.42 / $1,479.11 / $2,691.53
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $676.08 / $676.08
Security Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$223.87 / $223.87 / $223.87
Security Health
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$457.09 / $457.09 / $457.09
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,621.81 / $2,089.30
Security Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$263.03 / $295.12 / $489.78
Security Health
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$691.83 / $758.58 / $1,412.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $630.96 / $1,380.38
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$91.20 / $165.96 / $549.54
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$234.42 / $446.68 / $912.01