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Wyoming 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
$81.33 / $81.33 / $82.81
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.09 / $333.04 / $490.99
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$78.34 / $87.04 / $114.21
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$159.53 / $218.84 / $403.94
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.00 / $1,334.00 / $1,334.00
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$216.00 / $355.00 / $355.00
BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$596.00 / $979.00 / $979.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$397.71 / $596.55 / $1,099.01
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$99.63 / $150.50 / $259.48
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$277.23 / $436.61 / $825.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$390.87 / $599.91 / $1,455.30
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$77.40 / $160.99 / $281.62
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$311.32 / $455.52 / $1,173.68