go back

Montana rates for HCPCS 0523T

Intraprocedural coronary fractional flow reserve (FFR) with 3D functional mapping of color-coded FFR values for the coronary tree, derived from coronary angiogram data, for real-time review and interpretation of possible atherosclerotic stenosis(es) intervention (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.40 / $103.40 / $122.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$175.62 / $175.62 / $208.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$175.62 / $175.62 / $175.62
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$175.62 / $175.62 / $208.75
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$175.62 / $258.19 / $258.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$220.21 / $264.69 / $394.11