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North Carolina rates for HCPCS 72193

Computed tomography, pelvis; with contrast material(s)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$55.04 / $63.06 / $92.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$224.25 / $267.55 / $981.36
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$50.07 / $58.49 / $202.51
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$169.21 / $210.98 / $380.07
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$170.36 / $563.58 / $563.58
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$40.94 / $73.65 / $138.75
Ambetter
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$155.57 / $155.57 / $155.57
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.77 / $144.77 / $144.77
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$91.72 / $135.12 / $167.80
BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$378.43 / $443.28 / $713.95
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$62.89 / $62.89 / $62.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$273.88 / $429.19 / $736.91
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$53.34 / $90.64 / $159.05
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$208.62 / $333.78 / $581.29
Medcost
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$83.78 / $123.00 / $182.00
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.00 / $209.00 / $319.00
Medcost
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$83.78 / $83.78 / $202.58
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.87 / $208.25 / $382.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$231.12 / $354.12 / $642.66
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$55.68 / $82.87 / $162.38
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$173.46 / $261.20 / $469.40
Wellcare
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$397.76 / $501.04 / $501.04
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,871.61 / $1,871.61 / $1,931.70
Wellcare
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$364.90 / $364.90 / $438.60
Wellcare
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$1,571.91 / $1,571.91 / $1,571.91