go back

California rates for HCPCS 73721

Mri Any Jt Lower Extrem W/O Contrast Matrl

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$140.00 / $175.00 / $394.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$206.27 / $475.00 / $1,446.00
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$69.59 / $149.00 / $416.99
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$475.00 / $475.00 / $2,126.13
Aetna
Facility/Professional
Professional
Modifier
52
Low / Median / High Price
$104.71 / $237.50 / $662.98
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$172.16 / $335.00 / $917.81
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$167.62 / $221.25 / $571.14
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$47.37 / $77.25 / $143.97
Ambetter
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$98.96 / $150.81 / $296.79
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$261.04 / $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
$331.38 / $391.56 / $775.69
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$182.72 / $450.33 / $797.79
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$195.29 / $299.72 / $726.39
Blue Shield
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$60.35 / $82.35 / $198.25
Blue Shield
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$140.38 / $218.56 / $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
$189.97 / $424.00 / $878.19
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$38.74 / $75.47 / $180.40
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
$136.51 / $333.45 / $694.80
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$196.92 / $266.83 / $360.22
Contra Costa Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$53.17 / $71.31 / $96.28
Contra Costa Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$143.75 / $195.51 / $263.94
HealthNet
Facility/Professional
Professional
Modifier
Low / Median / High Price
$291.01 / $291.01 / $291.01
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$207.86 / $285.00 / $516.12
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
$166.75 / $237.87 / $522.01
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
$2,791.06 / $2,873.43 / $2,873.43
Lucent Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$525.38 / $525.38 / $525.38
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
$196.74 / $455.76 / $752.40
Providence
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$37.44 / $73.36 / $177.36
Providence
Facility/Professional
Professional
Modifier
52
Low / Median / High Price
$245.10 / $245.10 / $245.10
Providence
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$128.55 / $345.82 / $690.27
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$762.96 / $762.96 / $762.96
Sutter Health Plus
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$220.70 / $220.70 / $220.70
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
$215.79 / $296.70 / $952.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$197.56 / $344.85 / $744.07
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$51.97 / $69.29 / $170.18
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$138.66 / $230.52 / $577.59