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Delaware rates for HCPCS 72195

Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$69.48 / $90.19 / $323.81
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$238.82 / $425.00 / $522.50
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$70.20 / $126.00 / $151.19
Aetna
Facility/Professional
Professional
Modifier
52
Low / Median / High Price
$119.41 / $212.50 / $212.50
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$168.61 / $299.00 / $368.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$233.38 / $467.33 / $665.27
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$50.47 / $76.15 / $126.61
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$160.13 / $331.89 / $583.38
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.32 / $234.32 / $234.32
Highmark BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$67.75 / $68.65 / $86.86
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$220.16 / $368.77 / $679.33
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$57.93 / $82.58 / $166.89
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$164.66 / $253.81 / $585.95