go back

Montana rates for HCPCS 0633T

Computed tomography, breast, including 3D rendering, when performed, unilateral; without contrast material

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$183.53 / $223.25 / $273.70
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$315.48 / $315.48 / $375.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$315.48 / $315.48 / $474.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$199.98 / $241.06 / $375.00
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$315.48 / $315.48 / $474.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$94.44 / $94.44 / $195.11