go back

Minnesota rates for HCPCS 72193

Computed tomography, pelvis; with contrast material(s)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$52.48 / $56.23 / $85.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $302.00 / $794.33
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$52.48 / $85.11 / $186.21
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$162.18 / $218.78 / $436.52
BCBS
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$39.81 / $45.71 / $45.71
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.19 / $562.34 / $831.76
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$89.13 / $131.83 / $194.98
BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$288.40 / $446.68 / $630.96
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$44.67 / $173.78 / $478.63
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$288.40 / $446.68 / $741.31
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$58.88 / $104.71 / $169.82
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$218.78 / $346.74 / $575.44
Health Partners
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$154.88 / $194.98 / $380.19
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $354.81 / $549.54
Health Partners
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$81.28 / $81.28 / $128.82
Health Partners
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$275.42 / $275.42 / $426.58
Medica
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$512.86 / $512.86 / $512.86
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.47 / $446.68 / $1,819.70
Medica
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$58.88 / $114.82 / $363.08
Medica
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$186.21 / $331.13 / $1,513.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.47 / $416.87 / $758.58
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$57.54 / $95.50 / $173.78
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$186.21 / $316.23 / $588.84