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Ohio rates for HCPCS 72193

Computed tomography, pelvis; with contrast material(s)

Facilitymedian $68 · 10th–90th $56$1070%20%10th90th$68Professionalmedian $186 · 10th–90th $58$4370%10%10th90th$186$1.0$5.0$20.0$100.0$500.0$2.0K

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$56.23 / $67.61 / $107.15
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $295.12 / $660.69
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$52.48 / $89.13 / $190.55
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$158.49 / $218.78 / $446.68
Ambetter
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$41.69 / $51.29 / $81.28
Ambetter
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$112.20 / $112.20 / $112.20
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $316.23 / $512.86
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$58.88 / $75.86 / $123.03
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$190.55 / $239.88 / $398.11
Aultcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $245.47 / $426.58
Aultcare
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$60.26 / $60.26 / $104.71
Aultcare
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$181.97 / $181.97 / $316.23
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $194.98 / $331.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $316.23 / $575.44
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$47.86 / $74.13 / $128.82
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$158.49 / $251.19 / $446.68
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$13.49 / $61.66 / $89.13
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $316.23 / $575.44
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$48.98 / $74.13 / $144.54
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$154.88 / $239.88 / $446.68
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $144.54
SummaCare
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$213.80 / $213.80 / $213.80
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $177.83 / $398.11
SummaCare
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$52.48 / $67.61 / $114.82
SummaCare
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$83.18 / $107.15 / $309.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $275.42 / $489.78
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$46.77 / $64.57 / $120.23
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$147.91 / $204.17 / $346.74