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Wisconsin rates for HCPCS 72195

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

Facilitymedian $186 · 10th–90th $145$5500%20%10th90th$186Professionalmedian $269 · 10th–90th $85$8710%5%10th90th$269$50.0$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
$144.54 / $186.21 / $223.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $549.54 / $1,258.93
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$69.18 / $147.91 / $512.86
Aetna
Facility/Professional
Professional
Modifier
52
Typical Low / Median / Typical High
$2,187.76 / $2,187.76 / $2,187.76
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$177.83 / $338.84 / $575.44
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $446.68 / $1,412.54
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$67.61 / $107.15 / $398.11
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$162.18 / $331.13 / $1,047.13
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $194.98 / $281.84
Cigna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$181.97 / $213.80 / $338.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $691.83 / $954.99
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$74.13 / $173.78 / $281.84
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$234.42 / $489.78 / $676.08
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $512.86 / $794.33
DeanCare
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$125.89 / $151.36 / $208.93
DeanCare
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$302.00 / $354.81 / $616.60
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
$309.03 / $676.08 / $3,467.37
Medica
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$77.62 / $162.18 / $575.44
Medica
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$223.87 / $524.81 / $2,454.71
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $549.54
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $691.83 / $1,000.00
Network Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$95.50 / $162.18 / $275.42
Network Health
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$251.19 / $616.60 / $977.24
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $575.44 / $1,122.02
Quartz
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$162.18 / $630.96 / $630.96
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $1,621.81 / $3,630.78
Quartz
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$100.00 / $363.08 / $575.44
Quartz
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$257.04 / $1,380.38 / $2,570.40
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $630.96 / $630.96
Security Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$181.97 / $181.97 / $181.97
Security Health
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$446.68 / $446.68 / $446.68
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $1,659.59 / $2,398.83
Security Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$302.00 / $407.38 / $489.78
Security Health
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$851.14 / $1,778.28 / $2,041.74
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $776.25 / $1,819.70
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$87.10 / $251.19 / $537.03
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$199.53 / $436.52 / $812.83