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Missouri rates for HCPCS 0504T

Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation software analysis of functional data to assess the severity of coronary artery disease; anatomical data review in comparison with estimated FFR model to reconcile discordant data, interpretation and report

Facilitymedian $107 · 10th–90th $41–$1620%20%40%10th90th$107Professionalmedian $76 · 10th–90th $24–$4680%5%10%10th90th$76$20.0$50.0$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $41.69 / $52.48
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $107.15 / $162.18
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $467.74 / $467.74
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$40.74 / $40.74 / $72.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $67.61 / $147.91