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Wyoming 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
$55.06 / $55.06 / $56.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.49 / $296.25 / $437.49
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$52.46 / $58.30 / $77.81
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$159.22 / $218.42 / $379.19
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$677.00 / $1,112.00 / $1,112.00
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$147.00 / $241.00 / $241.00
BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$530.00 / $871.00 / $871.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$339.56 / $509.34 / $841.30
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$66.27 / $100.24 / $192.00
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$258.54 / $387.81 / $681.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$321.73 / $485.50 / $1,113.19
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$51.70 / $109.66 / $188.09
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$270.02 / $403.18 / $925.10