go back

Nebraska rates for HCPCS 72195

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

Facilitymedian $155 · 10th–90th $117$6310%10%20%10th90th$155Professionalmedian $214 · 10th–90th $74$7590%10%10th90th$214$20.0$50.0$100.0$200.0$500.0$1.0K$2.0K

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
$117.49 / $147.91 / $630.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $524.81 / $1,148.15
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$66.07 / $125.89 / $199.53
Aetna
Facility/Professional
Professional
Modifier
52
Typical Low / Median / Typical High
$281.84 / $281.84 / $281.84
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$144.54 / $281.84 / $616.60
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $524.81 / $524.81
Ambetter
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$91.20 / $117.49 / $158.49
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $426.58 / $467.74
BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$123.03 / $128.82 / $138.04
BCBS
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$251.19 / $295.12 / $501.19
Cigna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$389.05 / $389.05 / $389.05
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $549.54 / $891.25
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$107.15 / $147.91 / $199.53
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$269.15 / $380.19 / $724.44
Medica
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$645.65 / $645.65 / $645.65
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $588.84 / $3,467.37
Medica
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$83.18 / $134.90 / $575.44
Medica
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$213.80 / $446.68 / $2,454.71
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $524.81 / $794.33
Midlands
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$134.90 / $151.36 / $234.42
Midlands
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$316.23 / $363.08 / $549.54
Midlands
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$389.05 / $389.05 / $389.05
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $794.33 / $891.25
Midlands
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$134.90 / $141.25 / $234.42
Midlands
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$363.08 / $549.54 / $741.31
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $165.96 / $380.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $489.78 / $1,047.13
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$83.18 / $134.90 / $177.83
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$213.80 / $363.08 / $549.54