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Vermont rates for HCPCS 72194

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

Facilitymedian $355 · 10th–90th $355–$3550%50%100%$355Professionalmedian $229 · 10th–90th $62–$4570%5%10%10th90th$229$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $346.74 / $602.56
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$57.54 / $70.79 / $123.03
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$173.78 / $288.40 / $380.19
BCBS
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$354.81 / $354.81 / $354.81
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $478.63 / $1,122.02
BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$75.86 / $75.86 / $239.88
BCBS
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$398.11 / $398.11 / $478.63
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $512.86 / $977.24
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$74.13 / $85.11 / $181.97
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$169.82 / $426.58 / $758.58
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $281.84 / $281.84
MVP Health Care
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$61.66 / $61.66 / $61.66
MVP Health Care
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$218.78 / $218.78 / $218.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $389.05 / $891.25
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$58.88 / $75.86 / $147.91
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$204.17 / $288.40 / $575.44