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Idaho rates for HCPCS 72193

Ct Pelvis W/Contrast Material

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$79.34 / $146.09 / $147.32
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$267.55 / $322.50 / $488.67
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$50.07 / $62.00 / $122.77
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$217.43 / $266.89 / $365.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$192.51 / $215.16 / $441.38
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$45.95 / $51.35 / $104.72
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$146.57 / $163.81 / $328.78
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$848.05 / $848.05 / $941.41
Hally Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$282.16 / $282.16 / $440.88
Hally Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$500.53 / $500.53 / $565.89
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$368.26 / $424.06 / $560.38
Moda Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$86.99 / $100.17 / $117.04
Moda Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$281.27 / $323.89 / $378.44
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $98.67 / $358.93
Regence BlueShield
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$346.39 / $346.39 / $346.39
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$388.31 / $482.93 / $560.38
Regence BlueShield
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$94.90 / $111.65 / $134.44
Regence BlueShield
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$315.58 / $371.27 / $425.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.90 / $258.77 / $512.83
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$48.32 / $62.32 / $118.38
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$158.59 / $196.46 / $407.60