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New York 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
$61.66 / $87.10 / $190.55
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.78 / $302.00 / $741.31
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$52.48 / $70.79 / $165.96
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$162.18 / $218.78 / $457.09
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.96 / $165.96 / $204.17
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$107.15 / $107.15 / $107.15
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.93 / $263.03 / $741.31
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$50.12 / $63.10 / $125.89
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$158.49 / $199.53 / $537.03
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.18 / $245.47 / $331.13
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$14.13 / $66.07 / $93.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.88 / $436.52 / $1,659.59
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$44.67 / $85.11 / $234.42
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$177.83 / $371.54 / $1,148.15
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.47 / $323.59 / $489.78
Emblem Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$57.54 / $83.18 / $239.88
Emblem Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$190.55 / $257.04 / $371.54
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $338.84 / $616.60
Excellus BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$46.77 / $83.18 / $144.54
Excellus BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$162.18 / $269.15 / $467.74
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $269.15 / $316.23
Highmark BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$63.10 / $69.18 / $144.54
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$316.23 / $371.54 / $676.08
MVP Health Care
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$69.18 / $83.18 / $151.36
MVP Health Care
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$245.47 / $288.40 / $524.81
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.78 / $323.59 / $630.96
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$47.86 / $63.10 / $131.83
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$169.82 / $251.19 / $512.86
Univera
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$46.77 / $67.61 / $194.98
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $316.23 / $645.65
Univera
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$46.77 / $83.18 / $154.88
Univera
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$154.88 / $263.03 / $501.19