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New Hampshire rates for HCPCS 72197

Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences

Facilitymedian $158 · 10th–90th $129$4170%20%10th90th$158Professionalmedian $347 · 10th–90th $120$8710%5%10th90th$347$20.0$100.0$500.0$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
$128.82 / $158.49 / $416.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $537.03 / $1,819.70
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$104.71 / $158.49 / $346.74
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$245.47 / $338.84 / $758.58
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $275.42 / $812.83
Ambetter
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$81.28 / $128.82 / $338.84
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $812.83 / $1,148.15
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$102.33 / $234.42 / $338.84
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$234.42 / $549.54 / $870.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $794.33 / $1,905.46
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$117.49 / $181.97 / $316.23
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$323.59 / $562.34 / $1,584.89
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $616.60 / $954.99
Harvard Pilgrim
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$117.49 / $181.97 / $281.84
Harvard Pilgrim
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$275.42 / $426.58 / $660.69
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $758.58 / $1,348.96
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$112.20 / $165.96 / $331.13
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$281.84 / $478.63 / $1,023.29
Well Sense
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$77.62 / $85.11 / $104.71