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California rates for HCPCS 73221

Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$140.00 / $169.68 / $397.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$222.61 / $498.75 / $1,465.00
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$71.04 / $140.00 / $387.56
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$1,218.00 / $1,218.00 / $2,037.89
Aetna
Facility/Professional
Professional
Modifier
52
Low / Median / High Price
$104.87 / $237.50 / $665.13
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$168.55 / $335.00 / $812.00
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$170.75 / $215.16 / $452.57
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$48.33 / $86.30 / $143.97
Ambetter
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$441.47 / $441.47 / $441.47
Ambetter
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$99.19 / $307.93 / $307.93
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$260.69 / $532.92 / $952.35
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$60.25 / $84.07 / $168.84
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$331.90 / $391.03 / $776.94
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$183.13 / $450.33 / $797.79
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.99 / $299.24 / $727.52
Blue Shield
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$60.35 / $82.35 / $199.48
Blue Shield
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$140.09 / $218.10 / $521.21
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$73.64 / $73.64 / $73.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$192.37 / $413.85 / $835.45
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$38.97 / $78.58 / $182.19
Cigna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$301.29 / $301.29 / $343.71
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$138.05 / $314.93 / $686.17
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$197.26 / $267.29 / $360.84
Contra Costa Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$53.26 / $71.31 / $96.28
Contra Costa Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$144.00 / $195.96 / $264.55
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.22 / $285.00 / $517.00
Kaiser Permanente
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$64.19 / $92.72 / $400.00
Kaiser Permanente
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$167.14 / $238.43 / $523.21
Lucent Health
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$586.88 / $586.88 / $603.28
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,789.74 / $2,873.43 / $2,873.43
Lucent Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$542.85 / $542.85 / $542.85
Lucent Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$2,451.15 / $2,524.69 / $2,524.69
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $161.25
Providence
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$73.64 / $73.64 / $73.64
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$200.34 / $439.98 / $743.00
Providence
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$38.96 / $77.08 / $177.36
Providence
Facility/Professional
Professional
Modifier
52
Low / Median / High Price
$245.49 / $245.49 / $246.99
Providence
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$136.97 / $326.95 / $674.70
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$765.46 / $765.46 / $765.46
Sutter Health Plus
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$223.20 / $223.20 / $223.20
Sutter Health Plus
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$542.26 / $542.26 / $542.26
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$216.16 / $297.22 / $952.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$198.48 / $358.64 / $713.34
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$52.55 / $70.37 / $165.43
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$138.66 / $244.69 / $577.65