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Wisconsin rates for HCPCS 72194

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

Facilitymedian $151 · 10th–90th $112$5250%20%40%10th90th$151Professionalmedian $234 · 10th–90th $62$6170%5%10th90th$234$50.0$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
$112.20 / $112.20 / $120.23
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $288.40 / $489.78
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$54.95 / $83.18 / $147.91
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$169.82 / $218.78 / $398.11
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $398.11 / $1,412.54
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$56.23 / $89.13 / $331.13
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$199.53 / $309.03 / $1,148.15
Cigna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$151.36 / $177.83 / $281.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $691.83 / $1,047.13
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$61.66 / $134.90 / $234.42
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$218.78 / $537.03 / $831.76
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $562.34 / $758.58
DeanCare
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$104.71 / $128.82 / $173.78
DeanCare
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$363.08 / $436.52 / $588.84
Medica
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$537.03 / $537.03 / $537.03
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $616.60 / $2,187.76
Medica
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$63.10 / $123.03 / $436.52
Medica
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$245.47 / $489.78 / $1,905.46
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $389.05
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $562.34 / $933.25
Network Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$79.43 / $134.90 / $218.78
Network Health
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$302.00 / $467.74 / $724.44
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $630.96 / $1,230.27
Quartz
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$134.90 / $524.81 / $524.81
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $1,258.93 / $2,238.72
Quartz
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$83.18 / $302.00 / $436.52
Quartz
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$275.42 / $1,071.52 / $1,949.84
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $602.56 / $602.56
Security Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$151.36 / $151.36 / $151.36
Security Health
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$457.09 / $457.09 / $457.09
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $1,479.11 / $1,737.80
Security Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$199.53 / $213.80 / $331.13
Security Health
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$645.65 / $758.58 / $1,288.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $501.19 / $977.24
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$87.10 / $263.03 / $436.52
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$213.80 / $389.05 / $758.58