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Utah rates for HCPCS 72193

Computed tomography, pelvis; with contrast material(s)

Facilitymedian $65 · 10th–90th $65$650%50%$65Professionalmedian $209 · 10th–90th $56$4470%5%10%10th90th$209$10.0$50.0$200.0$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
$64.57 / $64.57 / $64.57
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $316.23 / $1,230.27
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$52.48 / $95.50 / $213.80
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$169.82 / $229.09 / $416.87
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $309.03 / $489.78
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$48.98 / $67.61 / $117.49
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$154.88 / $234.42 / $380.19
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $363.08
Regence BlueShield
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$323.59 / $323.59 / $323.59
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $398.11 / $489.78
Regence BlueShield
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$75.86 / $89.13 / $128.82
Regence BlueShield
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$251.19 / $302.00 / $363.08
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $331.13 / $537.03
Select Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$52.48 / $112.20 / $173.78
Select Health
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$162.18 / $218.78 / $316.23
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $251.19 / $407.38
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $257.04 / $416.87
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$47.86 / $50.12 / $97.72
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$147.91 / $194.98 / $331.13