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South Carolina rates for HCPCS 72193

Ct Pelvis W/Contrast Material

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$77.34 / $83.00 / $103.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$224.25 / $275.00 / $427.24
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$50.07 / $65.31 / $112.92
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$169.21 / $220.00 / $357.09
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$170.36 / $170.36 / $222.33
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$40.94 / $55.09 / $91.74
Ambetter
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$155.57 / $155.57 / $217.80
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$206.82 / $381.00 / $607.50
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$51.25 / $103.00 / $181.10
BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$155.57 / $278.00 / $448.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.96 / $336.74 / $581.44
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$53.34 / $76.98 / $141.47
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$175.40 / $255.15 / $446.24
Medcost
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$83.78 / $122.69 / $182.00
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$145.72 / $145.72 / $825.24
Medcost
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$202.58 / $202.58 / $202.58
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.14 / $199.33 / $304.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$226.19 / $312.14 / $535.35
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$54.42 / $76.95 / $125.58
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$169.12 / $242.55 / $422.15