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Maine rates for HCPCS 72195

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

Facilitymedian $95 · 10th–90th $95$1660%50%90th$95Professionalmedian $251 · 10th–90th $89$6030%5%10th90th$251$50.0$200.0$1.0K$5.0K$20.0K

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
Facility
Modifier
26
Typical Low / Median / Typical High
$95.50 / $95.50 / $165.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $478.63 / $977.24
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$70.79 / $141.25 / $223.87
Aetna
Facility/Professional
Professional
Modifier
52
Typical Low / Median / Typical High
$213.80 / $213.80 / $1,995.26
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$186.21 / $281.84 / $588.84
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $331.13 / $851.14
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$66.07 / $100.00 / $229.09
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$162.18 / $234.42 / $602.56
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $549.54 / $977.24
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$69.18 / $100.00 / $204.17
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$223.87 / $467.74 / $758.58
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $346.74 / $645.65
Harvard Pilgrim
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$81.28 / $102.33 / $190.55
Harvard Pilgrim
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$194.98 / $245.47 / $457.09
Martin's Point
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$85.11 / $165.96 / $9,549.93
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $478.63 / $891.25
Martin's Point
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$85.11 / $123.03 / $218.78
Martin's Point
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$194.98 / $331.13 / $630.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $436.52 / $891.25
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$72.44 / $102.33 / $263.03
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$190.55 / $309.03 / $616.60