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Montana rates for HCPCS 0558T

Computed tomography scan taken for the purpose of biomechanical computed tomography analysis

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$150.65 / $230.50 / $274.56
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$358.60 / $358.60 / $426.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$322.74 / $358.60 / $538.78
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$150.65 / $274.56 / $426.25
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$358.60 / $358.60 / $538.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$185.34 / $190.88 / $385.99