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Oklahoma 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
$63.28 / $97.93 / $117.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$209.41 / $312.55 / $475.00
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$62.50 / $97.93 / $140.00
Aetna
Facility/Professional
Professional
Modifier
52
Low / Median / High Price
$104.71 / $125.00 / $176.41
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$142.22 / $214.63 / $335.00
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$149.38 / $205.76 / $306.75
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$47.72 / $59.66 / $88.95
Ambetter
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$142.49 / $160.26 / $252.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.40 / $206.85 / $284.02
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$61.82 / $61.82 / $99.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$175.62 / $338.28 / $601.01
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$55.92 / $63.60 / $107.05
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$118.35 / $232.43 / $509.30
Medica
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$466.08 / $603.28 / $603.28
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$202.21 / $285.42 / $2,791.06
Medica
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$54.76 / $73.11 / $525.38
Medica
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$141.91 / $279.52 / $2,451.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$185.94 / $236.78 / $534.70
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$54.76 / $69.29 / $137.12
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$141.91 / $173.57 / $448.20