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New York rates for HCPCS 72196

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$101.83 / $119.21 / $221.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$279.67 / $425.00 / $770.80
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$82.33 / $119.50 / $196.04
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$196.89 / $297.99 / $536.09
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$203.95 / $203.95 / $203.95
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$61.00 / $61.00 / $61.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.79 / $360.51 / $1,131.04
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$75.62 / $93.90 / $194.33
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$200.16 / $261.66 / $888.69
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119.95 / $306.80 / $426.75
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$93.41 / $93.41 / $93.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$260.63 / $639.96 / $1,466.33
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$62.26 / $117.15 / $255.12
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$184.52 / $465.15 / $1,192.10
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$280.89 / $388.15 / $782.39
Emblem Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$76.89 / $105.45 / $169.16
Emblem Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$195.23 / $255.19 / $408.99
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$252.87 / $430.31 / $571.82
Excellus BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$38.72 / $96.87 / $170.77
Excellus BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$175.99 / $307.10 / $401.04
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$373.00 / $373.00 / $373.00
Highmark BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$106.29 / $106.29 / $107.46
MVP Health Care
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$93.41 / $93.41 / $93.41
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$309.98 / $663.66 / $1,375.85
MVP Health Care
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$63.49 / $123.00 / $250.24
MVP Health Care
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$211.19 / $516.00 / $987.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$243.59 / $353.53 / $862.36
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$70.09 / $89.33 / $231.46
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$182.18 / $258.67 / $749.98
Univera
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$95.27 / $95.27 / $278.70
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$276.82 / $424.26 / $758.12
Univera
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$38.72 / $124.05 / $225.73
Univera
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$194.14 / $300.20 / $532.39