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Wisconsin rates for HCPCS 72193

Computed tomography, pelvis; with contrast material(s)

Facilitymedian $162 · 10th–90th $107$5010%10%10th90th$162Professionalmedian $214 · 10th–90th $59$6170%5%10th90th$214$10.0$50.0$200.0$1.0K$5.0K

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
$107.15 / $114.82 / $181.97
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $302.00 / $575.44
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$52.48 / $107.15 / $239.88
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$169.82 / $218.78 / $416.87
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $363.08 / $1,348.96
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$53.70 / $85.11 / $316.23
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$177.83 / $275.42 / $1,023.29
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $208.93 / $281.84
Cigna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$144.54 / $169.82 / $269.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $588.84 / $954.99
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$58.88 / $128.82 / $223.87
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$186.21 / $467.74 / $741.31
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $512.86 / $691.83
DeanCare
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$100.00 / $120.23 / $162.18
DeanCare
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$323.59 / $389.05 / $524.81
Medica
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$512.86 / $512.86 / $512.86
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $537.03 / $1,819.70
Medica
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$60.26 / $123.03 / $363.08
Medica
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$204.17 / $416.87 / $1,513.56
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $295.12
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $489.78 / $831.76
Network Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$75.86 / $128.82 / $208.93
Network Health
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$269.15 / $363.08 / $616.60
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $575.44 / $1,122.02
Quartz
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$128.82 / $501.19 / $501.19
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $1,148.15 / $1,862.09
Quartz
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$79.43 / $288.40 / $363.08
Quartz
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$239.88 / $870.96 / $1,584.89
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $602.56 / $602.56
Security Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$144.54 / $144.54 / $144.54
Security Health
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$457.09 / $457.09 / $457.09
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,380.38 / $1,584.89
Security Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$186.21 / $194.98 / $316.23
Security Health
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$537.03 / $630.96 / $1,122.02
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $851.14 / $1,862.09
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$85.11 / $199.53 / $416.87
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$186.21 / $331.13 / $660.69