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Wyoming rates for HCPCS 72193

Ct Pelvis W/Contrast Material

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$52.47 / $52.47 / $53.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$210.70 / $279.43 / $339.08
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$50.07 / $55.67 / $73.84
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$159.25 / $217.46 / $283.41
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$614.00 / $1,009.00 / $1,009.00
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$140.00 / $230.00 / $230.00
BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$474.00 / $779.00 / $779.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$290.63 / $421.83 / $750.55
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$63.17 / $95.53 / $166.50
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$217.17 / $325.75 / $597.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.25 / $474.34 / $737.31
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$49.39 / $106.55 / $179.29
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$201.86 / $335.84 / $694.11