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Montana rates for HCPCS 72194

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

Facilitymedian $89 · 10th–90th $89$1100%20%40%90th$89Professionalmedian $263 · 10th–90th $62$6030%5%10th90th$263$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
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $416.87 / $1,348.96
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$54.95 / $89.13 / $144.54
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$181.97 / $281.84 / $467.74
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $575.44
Cigna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$89.13 / $89.13 / $109.65
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $407.38 / $724.44
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$39.81 / $89.13 / $162.18
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$208.93 / $323.59 / $562.34
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $446.68 / $602.56
Providence
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$89.13 / $89.13 / $109.65
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $575.44 / $724.44
Providence
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$58.88 / $89.13 / $131.83
Providence
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$218.78 / $323.59 / $478.63
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $316.23 / $537.03
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$52.48 / $53.70 / $131.83
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$169.82 / $263.03 / $426.58