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Rhode Island 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
$295.12 / $295.12 / $295.12
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.80 / $389.05 / $707.95
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$51.29 / $100.00 / $190.55
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$162.18 / $302.00 / $549.54
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$263.03 / $346.74 / $616.60
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$57.54 / $74.13 / $120.23
BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$186.21 / $213.80 / $295.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $512.86 / $758.58
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$48.98 / $112.20 / $128.82
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$173.78 / $398.11 / $602.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.42 / $371.54 / $588.84
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$52.48 / $69.18 / $112.20
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$213.80 / $281.84 / $457.09