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Montana rates for HCPCS 72193

Computed tomography, pelvis; with contrast material(s)

Facilitymedian $85 · 10th–90th $85$1070%20%40%90th$85Professionalmedian $229 · 10th–90th $59$5250%5%10th90th$229$50.0$100.0$200.0$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $371.54 / $1,230.27
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$52.48 / $97.72 / $234.42
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$181.97 / $269.15 / $467.74
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $85.11 / $371.54
Cigna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$85.11 / $85.11 / $107.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $371.54 / $645.65
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$38.02 / $85.11 / $151.36
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$177.83 / $269.15 / $489.78
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $407.38 / $588.84
Providence
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$85.11 / $85.11 / $107.15
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $524.81 / $660.69
Providence
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$56.23 / $85.11 / $125.89
Providence
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$199.53 / $275.42 / $426.58
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $251.19 / $478.63
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$50.12 / $58.88 / $125.89
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$144.54 / $199.53 / $363.08