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New Hampshire rates for HCPCS 73201

Computed tomography, upper extremity; with contrast material(s)

Facilitymedian $105 · 10th–90th $52$2140%20%10th90th$105Professionalmedian $195 · 10th–90th $60$4270%5%10th90th$195$50.0$100.0$200.0$500.0$1.0K$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
$52.48 / $104.71 / $213.80
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $257.04 / $407.38
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$48.98 / $67.61 / $169.82
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$144.54 / $204.17 / $323.59
Ambetter
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$42.66 / $42.66 / $42.66
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $467.74 / $676.08
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$53.70 / $123.03 / $177.83
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$144.54 / $338.84 / $501.19
Cigna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$69.18 / $69.18 / $69.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $416.87 / $741.31
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$61.66 / $100.00 / $165.96
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$194.98 / $309.03 / $588.84
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $363.08 / $549.54
Harvard Pilgrim
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$61.66 / $95.50 / $141.25
Harvard Pilgrim
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$169.82 / $263.03 / $389.05
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $346.74 / $724.44
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$58.88 / $87.10 / $165.96
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$173.78 / $257.04 / $457.09
Well Sense
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$40.74 / $44.67 / $53.70