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Delaware rates for HCPCS 72194

Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$64.57 / $75.86 / $151.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.78 / $288.40 / $602.56
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$51.29 / $67.61 / $144.54
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$169.82 / $213.80 / $407.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.04 / $389.05 / $562.34
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$40.74 / $67.61 / $107.15
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$194.98 / $302.00 / $457.09
Highmark BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$72.44 / $72.44 / $72.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.98 / $346.74 / $660.69
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$41.69 / $63.10 / $123.03
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$169.82 / $295.12 / $501.19