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Montana rates for HCPCS 0623T

Automated quantification and characterization of coronary atherosclerotic plaque to assess severity of coronary disease, using data from coronary computed tomographic angiography; data preparation and transmission, computerized analysis of data, with review of computerized analysis output to reconcile discordant data, interpretation and report

Insurance Carrier
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$732.35 / $732.35 / $732.35
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$738.12 / $738.12 / $738.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.44 / $277.24 / $315.47