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Maine rates for HCPCS 72200

Radiologic examination, sacroiliac joints; less than 3 views

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$10.00 / $10.00 / $10.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.88 / $33.11 / $75.86
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$6.03 / $8.91 / $25.70
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$15.14 / $23.99 / $45.71
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.18 / $43.65 / $61.66
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$6.61 / $10.72 / $15.14
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$21.88 / $31.62 / $44.67
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.18 / $42.66 / $75.86
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$8.32 / $12.02 / $19.95
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$19.50 / $30.90 / $57.54
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.74 / $51.29 / $102.33
Harvard Pilgrim
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$10.00 / $12.59 / $23.99
Harvard Pilgrim
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$30.90 / $38.90 / $75.86
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.84 / $41.69 / $85.11
Martin's Point
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$7.08 / $11.75 / $25.70
Martin's Point
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$19.95 / $30.90 / $61.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $42.66 / $83.18
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$8.71 / $12.30 / $22.39
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$21.38 / $31.62 / $56.23