go back

New Hampshire rates for HCPCS 72195

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

Facilitymedian $129 · 10th–90th $95$2690%20%40%10th90th$129Professionalmedian $257 · 10th–90th $98$6030%5%10th90th$257$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
$102.33 / $128.82 / $269.15
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $457.09 / $812.83
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$70.79 / $131.83 / $223.87
Aetna
Facility/Professional
Professional
Modifier
52
Typical Low / Median / Typical High
$213.80 / $281.84 / $1,995.26
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$169.82 / $302.00 / $549.54
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
Ambetter
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$53.70 / $53.70 / $218.78
Ambetter
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$134.90 / $134.90 / $134.90
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $549.54 / $776.25
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$66.07 / $154.88 / $223.87
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$162.18 / $371.54 / $588.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $549.54 / $1,230.27
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$77.62 / $131.83 / $208.93
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$218.78 / $398.11 / $977.24
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $416.87 / $645.65
Harvard Pilgrim
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$77.62 / $120.23 / $186.21
Harvard Pilgrim
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$190.55 / $295.12 / $457.09
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $478.63 / $891.25
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$74.13 / $109.65 / $218.78
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$194.98 / $331.13 / $645.65
Well Sense
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$51.29 / $56.23 / $67.61