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New Hampshire rates for HCPCS 72194

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

Facilitymedian $224 · 10th–90th $58$2240%50%10th$224Professionalmedian $234 · 10th–90th $65$5620%5%10th90th$234$50.0$100.0$200.0$500.0$1.0K$2.0K

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
$223.87 / $223.87 / $223.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $281.84 / $602.56
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$51.29 / $64.57 / $128.82
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$169.82 / $218.78 / $380.19
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $588.84 / $851.14
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$56.23 / $128.82 / $186.21
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$177.83 / $446.68 / $660.69
Cigna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$72.44 / $72.44 / $72.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $524.81 / $912.01
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$64.57 / $102.33 / $173.78
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$234.42 / $426.58 / $758.58
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $457.09 / $691.83
Harvard Pilgrim
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$64.57 / $102.33 / $147.91
Harvard Pilgrim
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$229.09 / $354.81 / $524.81
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $426.58 / $851.14
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$61.66 / $91.20 / $173.78
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$229.09 / $346.74 / $602.56
Well Sense
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$42.66 / $46.77 / $57.54