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Texas 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
$52.98 / $82.03 / $99.99
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$195.32 / $346.43 / $725.00
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$60.32 / $101.92 / $254.90
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$475.00 / $475.00 / $475.00
Aetna
Facility/Professional
Professional
Modifier
52
Low / Median / High Price
$97.66 / $144.01 / $273.75
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$135.00 / $235.16 / $502.50
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.11 / $168.59 / $341.62
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$48.61 / $63.24 / $118.49
Ambetter
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$78.00 / $104.65 / $111.40
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.72 / $158.25 / $245.90
Baylor Scott & White
Facility/Professional
Professional
Modifier
Low / Median / High Price
$191.35 / $287.37 / $568.03
Christus
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$60.15 / $64.23 / $115.72
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
$171.03 / $319.73 / $758.16
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$49.61 / $73.36 / $134.09
Cigna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$301.29 / $301.29 / $366.14
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$118.35 / $229.77 / $580.47
Lucent Health
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$466.08 / $586.88 / $603.28
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,056.00 / $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
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.98 / $294.02 / $800.88
Moda Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$80.31 / $101.94 / $247.12
Moda Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$179.97 / $228.43 / $335.02
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.59 / $167.47 / $368.90
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
$177.90 / $374.82 / $706.36
Providence
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$53.36 / $70.20 / $129.86
Providence
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$118.36 / $223.34 / $580.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$197.56 / $280.44 / $600.01
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$54.76 / $69.29 / $131.29
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$138.66 / $214.77 / $427.24
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$170.88 / $191.58 / $271.92
Wellpoint
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$52.73 / $60.76 / $83.89
Wellpoint
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$118.15 / $138.07 / $1,400.00