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Oklahoma rates for HCPCS 72197

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$103.48 / $164.31 / $209.76
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$250.00 / $475.00 / $594.67
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$62.50 / $136.69 / $173.65
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$187.50 / $335.00 / $421.04
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$340.35 / $423.50 / $423.50
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$77.67 / $96.17 / $164.61
Ambetter
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$133.52 / $133.52 / $133.52
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.95 / $352.45 / $483.96
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$103.76 / $103.76 / $166.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$290.39 / $568.12 / $928.71
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$91.90 / $104.40 / $172.18
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$197.20 / $403.64 / $790.33
Medica
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$759.68 / $973.04 / $973.04
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$345.06 / $512.04 / $6,025.38
Medica
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$91.80 / $118.69 / $891.52
Medica
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$247.72 / $487.96 / $5,457.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$345.06 / $457.14 / $1,088.33
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$91.80 / $111.88 / $188.82
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$247.72 / $331.37 / $893.68