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Wyoming rates for HCPCS 72196

Mri Pelvis W/Contrast Material

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$78.20 / $78.20 / $79.66
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$279.67 / $444.05 / $475.00
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$82.78 / $135.62 / $140.00
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$196.89 / $308.43 / $335.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$719.00 / $1,181.00 / $2,183.00
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$210.00 / $345.00 / $638.00
BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$509.00 / $836.00 / $1,545.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$439.32 / $642.82 / $1,240.00
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$94.20 / $142.44 / $309.14
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$311.69 / $469.37 / $906.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$486.05 / $608.77 / $1,684.09
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$72.04 / $152.52 / $266.33
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$351.67 / $437.42 / $1,417.89