go back

New Jersey rates for HCPCS 72193

Computed tomography, pelvis; with contrast material(s)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$47.00 / $65.79 / $238.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$210.70 / $279.89 / $495.07
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$47.00 / $57.84 / $122.91
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$159.25 / $217.46 / $348.53
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.47 / $157.63 / $170.60
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$40.27 / $44.96 / $79.00
AmeriHealth
Facility/Professional
Professional
Modifier
Low / Median / High Price
$170.95 / $170.95 / $600.00
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$37.97 / $37.97 / $37.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$189.59 / $338.49 / $584.54
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$38.95 / $68.84 / $115.98
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$144.55 / $264.36 / $475.27
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.47 / $357.96 / $770.52
Emblem Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$61.40 / $71.89 / $747.19
Emblem Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$207.50 / $249.63 / $747.19
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$198.66 / $233.72 / $416.79
Horizon BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$46.15 / $54.29 / $83.08
Horizon BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$152.52 / $179.43 / $322.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$197.97 / $294.48 / $476.63
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$45.04 / $65.11 / $110.11
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$146.72 / $224.08 / $371.94