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Wyoming 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
$99.99 / $99.99 / $101.85
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$351.45 / $475.00 / $558.10
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$104.88 / $140.00 / $215.62
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$246.57 / $335.00 / $386.22
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$903.00 / $1,483.00 / $2,741.00
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$265.00 / $435.00 / $804.00
BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$638.00 / $1,048.00 / $1,937.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$551.42 / $859.71 / $1,581.13
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$122.88 / $185.84 / $389.98
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$388.91 / $625.08 / $1,286.17
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$615.42 / $765.48 / $2,253.91
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$95.60 / $196.49 / $364.09
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$441.83 / $549.54 / $1,906.31