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Iowa rates for HCPCS 72195

Mri Pelvis W/O Contrast Material

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$63.90 / $138.79 / $358.55
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$244.12 / $475.00 / $1,729.00
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$68.42 / $126.00 / $282.00
Aetna
Facility/Professional
Professional
Modifier
52
Low / Median / High Price
$118.21 / $163.55 / $284.62
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$166.60 / $305.00 / $557.00
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$221.48 / $228.12 / $234.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$377.10 / $577.44 / $1,208.84
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$73.25 / $156.69 / $217.93
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$280.00 / $427.25 / $1,028.03
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$202.79 / $347.69 / $1,342.67
Hally Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$64.33 / $105.45 / $266.26
Hally Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$138.46 / $243.20 / $1,146.36
Medica
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$502.88 / $650.32 / $650.32
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$298.00 / $496.66 / $3,507.01
Medica
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$73.75 / $121.70 / $571.29
Medica
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$212.09 / $353.48 / $2,477.29
Midlands
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$228.12 / $234.77 / $385.32
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $602.19 / $884.61
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.66 / $232.57 / $399.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$270.31 / $429.32 / $772.34
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$73.22 / $107.39 / $216.22
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$194.41 / $309.30 / $553.58
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$408.11 / $516.60 / $607.79
Wellmark
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$121.19 / $153.40 / $180.40
Wellmark
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$287.01 / $363.30 / $427.40