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New Hampshire rates for HCPCS 72196

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

Facilitymedian $316 · 10th–90th $79$3160%50%10th$316Professionalmedian $295 · 10th–90th $110$6170%5%10th90th$295$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
$316.23 / $316.23 / $316.23
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $426.58 / $616.60
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$83.18 / $123.03 / $181.97
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$194.98 / $302.00 / $489.78
Ambetter
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$102.33 / $102.33 / $102.33
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $645.65 / $912.01
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$79.43 / $186.21 / $263.03
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$190.55 / $436.52 / $691.83
Cigna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$109.65 / $109.65 / $109.65
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $630.96 / $1,380.38
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$91.20 / $154.88 / $245.47
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$257.04 / $457.09 / $1,122.02
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $489.78 / $758.58
Harvard Pilgrim
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$91.20 / $144.54 / $223.87
Harvard Pilgrim
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$223.87 / $338.84 / $537.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $562.34 / $1,000.00
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$87.10 / $128.82 / $257.04
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$229.09 / $380.19 / $707.95
Well Sense
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$61.66 / $67.61 / $79.43