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Utah rates for HCPCS 72196

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

Facilitymedian $129 · 10th–90th $129$1290%50%$129Professionalmedian $295 · 10th–90th $93$6920%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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$128.82 / $128.82 / $128.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $478.63 / $1,737.80
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$81.28 / $128.82 / $257.04
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$204.17 / $338.84 / $602.56
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $537.03 / $831.76
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$72.44 / $100.00 / $177.83
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$181.97 / $398.11 / $691.83
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $562.34
Regence BlueShield
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$676.08 / $676.08 / $676.08
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $457.09 / $891.25
Regence BlueShield
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$112.20 / $134.90 / $194.98
Regence BlueShield
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$275.42 / $323.59 / $691.83
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $426.58 / $912.01
Select Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$77.62 / $190.55 / $223.87
Select Health
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$177.83 / $239.88 / $380.19
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $302.00 / $512.86
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $407.38 / $758.58
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$70.79 / $75.86 / $147.91
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$190.55 / $302.00 / $676.08