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Arkansas rates for HCPCS 72193

Computed tomography, pelvis; with contrast material(s)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$60.04 / $84.50 / $89.81
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$244.84 / $305.58 / $470.68
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$51.30 / $76.43 / $98.00
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$194.49 / $221.08 / $375.33
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$343.20 / $343.20 / $343.20
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$50.34 / $88.31 / $100.59
Ambetter
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$330.34 / $330.34 / $330.34
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.03 / $295.18 / $327.98
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$59.83 / $79.19 / $87.99
BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$163.19 / $215.99 / $239.99
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.54 / $171.95 / $259.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.96 / $338.55 / $519.09
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$53.03 / $80.27 / $119.57
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$146.63 / $262.85 / $385.00
Qualchoice
Facility/Professional
Professional
Modifier
Low / Median / High Price
$394.68 / $394.68 / $394.68
Qualchoice
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$98.19 / $101.56 / $128.80
Qualchoice
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$379.89 / $379.89 / $379.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$216.29 / $328.14 / $473.61
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$52.90 / $84.20 / $108.57
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$167.92 / $237.40 / $356.34