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South Dakota rates for HCPCS 72193

Computed tomography, pelvis; with contrast material(s)

Facilitymedian $56 · 10th–90th $56$560%50%$56Professionalmedian $186 · 10th–90th $54$4570%5%10%10th90th$186$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
Facility
Modifier
26
Typical Low / Median / Typical High
$39.81 / $56.23 / $56.23
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $275.42 / $457.09
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$52.48 / $95.50 / $151.36
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$162.18 / $208.93 / $354.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $549.54 / $691.83
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$102.33 / $128.82 / $158.49
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$338.84 / $426.58 / $537.03
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $354.81 / $1,819.70
Medica
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$57.54 / $93.33 / $363.08
Medica
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$169.82 / $288.40 / $1,513.56
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $489.78 / $524.81
Midlands
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$109.65 / $114.82 / $134.90
Midlands
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$346.74 / $371.54 / $389.05
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $489.78 / $489.78
Midlands
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$120.23 / $120.23 / $120.23
Midlands
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$371.54 / $371.54 / $371.54
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $380.19 / $446.68
Sanford Health Plan
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$67.61 / $91.20 / $104.71
Sanford Health Plan
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$213.80 / $295.12 / $346.74
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $407.38 / $562.34
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$58.88 / $97.72 / $144.54
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$194.98 / $323.59 / $426.58
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $524.81 / $524.81
Wellmark
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$104.71 / $123.03 / $123.03
Wellmark
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$338.84 / $398.11 / $398.11