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North Dakota rates for HCPCS 72192

Ct Pelvis W/O Contrast Material

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$38.25 / $38.25 / $87.68
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.54 / $176.66 / $325.00
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$42.70 / $51.10 / $140.40
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$64.29 / $107.34 / $227.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$260.56 / $328.63 / $344.64
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$100.60 / $124.15 / $129.77
BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$165.70 / $204.48 / $214.44
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$59.04 / $59.04 / $59.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.75 / $288.20 / $463.27
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$52.75 / $95.49 / $131.84
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$119.77 / $184.97 / $367.78
Medica
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$482.96 / $482.96 / $482.96
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$161.79 / $294.16 / $1,593.12
Medica
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$54.91 / $109.30 / $325.83
Medica
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$92.03 / $184.04 / $1,318.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$161.79 / $274.89 / $441.50
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$52.80 / $99.72 / $136.26
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$92.03 / $172.88 / $322.11