go back

Ohio 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
$85.19 / $146.36 / $285.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$277.24 / $370.50 / $587.75
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$83.67 / $111.15 / $155.65
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$192.05 / $259.35 / $393.48
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$61.52 / $61.52 / $62.89
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$320.02 / $417.17 / $723.95
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$80.17 / $96.01 / $169.81
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$220.03 / $319.20 / $564.30
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.59 / $186.19 / $301.63
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$85.02 / $93.41 / $93.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$260.63 / $465.00 / $913.35
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$70.98 / $110.95 / $185.70
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$184.52 / $355.45 / $718.16
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$85.02 / $85.02 / $93.41
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$270.77 / $457.51 / $935.28
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$77.66 / $112.12 / $183.99
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$186.19 / $324.56 / $663.38
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.87 / $209.12 / $343.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$273.77 / $424.54 / $736.13
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$67.05 / $95.68 / $174.18
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$193.17 / $277.45 / $576.79