MRI pelvis without and with contrast dye at Holy Name

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

MRI-PELV W/O CON&W/ RT PLAN

Teaneck, NJ

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Pricing by billing methodology

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How this price compares nationally

Holy Name’s median price of $1.2k is 32% above the median hospital's median price ($876), higher than 61% of the 2,583 hospitals reporting CPT 72197. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 72197 at Holy Name

Negotiated rates from the hospital’s own file: 9 payers, 25 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.

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1	Aetna medicare prime facility · fee schedule · outpatient	$379	$379	—	—	—	$379 – $379
2	Aetna medicare prime facility · percent of total billed charges · outpatientfrom % of charges	$414	$414	—	—	—	$414 – $414
3	Aetna golden medicare facility · fee schedule · outpatient	$421	$421	—	—	—	$421 – $421
4	Clover clover facility · fee schedule · outpatient	$421	$421	—	—	—	$421 – $421
5	UnitedHealthcare medicare facility · fee schedule · outpatient	$421	$421	—	—	—	$421 – $421
6	WellCare medicare facility · fee schedule · outpatient	$425	$425	—	—	—	$425 – $425
7	Aetna golden medicare facility · percent of total billed charges · outpatientfrom % of charges	$503	$503	—	—	—	$503 – $503
8	UnitedHealthcare medicaid facility · percent of total billed charges · outpatientfrom % of charges	$544	$545	$176	32%	—	$364 – $728
9	Aetna better health mcd/chip facility · percent of total billed charges · outpatientfrom % of charges	$571	$572	$185	32%	—	$382 – $764
10	Aetna qualified health plans facility · percent of total billed charges · outpatientfrom % of charges	$653	$655	$211	32%	—	$437 – $875
11	Aetna whole health facility · percent of total billed charges · outpatientfrom % of charges	$734	$734	—	—	—	$734 – $734
12	Aetna whole health facility · fee schedule · outpatient	$760	$760	—	—	—	$760 – $760
13	UnitedHealthcare uhc facility · other · outpatient	$810	$810	—	—	—	$810 – $810
14	Ambetter ambetter facility · percent of total billed charges · outpatientfrom % of charges	$851	$853	$275	32%	—	$570 – $1.1k
15	Cigna hmo/pos facility · percent of total billed charges · outpatientfrom % of charges	$1.1k	$1.1k	—	—	—	$1.1k – $1.1k
16	Aetna hmo/pos facility · percent of total billed charges · outpatientfrom % of charges	$1.1k	$1.1k	$371	32%	—	$768 – $1.5k
17	Cigna hmo/pos facility · fee schedule · outpatient	$1.3k	$1.3k	—	—	—	$1.3k – $1.3k
18	First Health first health facility · percent of total billed charges · outpatientfrom % of charges	$1.6k	$1.6k	$526	32%	—	$1.1k – $2.2k
19	Aetna worker's comp facility · percent of total billed charges · outpatientfrom % of charges	$2.1k	$2.1k	$671	32%	—	$1.4k – $2.8k
20	MultiPlan multiplan facility · percent of total billed charges · outpatientfrom % of charges	$2.2k	$2.2k	$715	32%	—	$1.5k – $3.0k
21	MultiPlan worker's comp facility · percent of total billed charges · outpatientfrom % of charges	$2.9k	$2.9k	$935	32%	—	$1.9k – $3.9k
22	MultiPlan auto accident medical facility · percent of total billed charges · outpatientfrom % of charges	$3.1k	$3.1k	$990	32%	—	$2.1k – $4.1k
23	Blue Cross Blue Shield indemnity facility · percent of total billed charges · outpatientfrom % of charges	$3.2k	$3.2k	$1.0k	32%	—	$2.1k – $4.2k
24	Blue Cross Blue Shield managed facility · percent of total billed charges · outpatientfrom % of charges	$3.2k	$3.2k	$1.0k	32%	—	$2.1k – $4.2k
25	Blue Cross Blue Shield ppo facility · percent of total billed charges · outpatientfrom % of charges	$3.2k	$3.2k	$1.0k	32%	—	$2.1k – $4.2k

Last updated: Nov 10, 2025

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