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Montana rates for HCPCS 72196

Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s)

Facilitymedian $126 · 10th–90th $126$1580%20%40%90th$126Professionalmedian $339 · 10th–90th $105$7590%5%10%10th90th$339$50.0$100.0$200.0$500.0$1.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $537.03 / $1,737.80
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$83.18 / $138.04 / $257.04
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$208.93 / $371.54 / $691.83
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $436.52
Cigna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$125.89 / $125.89 / $158.49
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $575.44 / $851.14
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$57.54 / $125.89 / $229.09
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$204.17 / $436.52 / $707.95
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $512.86 / $891.25
Providence
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$125.89 / $125.89 / $158.49
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $630.96 / $758.58
Providence
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$85.11 / $125.89 / $186.21
Providence
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$213.80 / $371.54 / $524.81
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $457.09 / $758.58
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$75.86 / $75.86 / $190.55
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$190.55 / $354.81 / $616.60