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Maine rates for HCPCS 72202

Radiologic examination, sacroiliac joints; 3 or more views

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$12.88 / $13.18 / $14.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $43.65 / $104.71
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$7.94 / $12.59 / $28.18
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$20.89 / $30.20 / $64.57
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.11 / $51.29 / $74.13
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$8.51 / $13.80 / $19.95
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$24.55 / $35.48 / $51.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.88 / $51.29 / $89.13
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$9.12 / $14.45 / $26.92
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$24.55 / $36.31 / $66.07
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.71 / $60.26 / $117.49
Harvard Pilgrim
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$12.59 / $15.85 / $29.51
Harvard Pilgrim
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$34.67 / $42.66 / $85.11
Martin's Point
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$12.88 / $13.18 / $14.79
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $51.29 / $97.72
Martin's Point
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$8.91 / $14.79 / $27.54
Martin's Point
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$25.12 / $36.31 / $72.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.48 / $48.98 / $97.72
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$11.48 / $14.13 / $26.30
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$25.12 / $35.48 / $63.10