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Ohio rates for HCPCS 73201

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

Facilitymedian $72 · 10th–90th $56$1070%20%10th90th$72Professionalmedian $170 · 10th–90th $56$3980%10%10th90th$170$1.0$5.0$20.0$100.0$500.0

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
$56.23 / $72.44 / $107.15
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $229.09 / $549.54
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$51.29 / $81.28 / $162.18
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$141.25 / $199.53 / $426.58
Ambetter
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$41.69 / $51.29 / $64.57
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $288.40 / $457.09
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$57.54 / $74.13 / $120.23
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$169.82 / $213.80 / $354.81
Aultcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $371.54 / $371.54
Aultcare
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$104.71 / $104.71 / $104.71
Aultcare
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$269.15 / $269.15 / $269.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $302.00 / $549.54
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$47.86 / $74.13 / $128.82
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$141.25 / $223.87 / $416.87
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$13.49 / $61.66 / $89.13
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $295.12 / $537.03
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$48.98 / $74.13 / $131.83
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$134.90 / $213.80 / $398.11
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $141.25
SummaCare
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$426.58 / $426.58 / $426.58
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $158.49 / $346.74
SummaCare
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$52.48 / $66.07 / $114.82
SummaCare
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$70.79 / $91.20 / $251.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $251.19 / $446.68
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$45.71 / $63.10 / $120.23
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$131.83 / $181.97 / $316.23