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Myelogram Of The Lower Back, Injection And X-ray Imaging

Montana rates for HCPCS 62304

A dye study of the lower back and tailbone portion of the spine. Contrast dye is injected through a needle into the fluid-filled space around the spinal cord and nerve roots, and x-ray images are then taken and interpreted. The injection and the imaging are both part of this service.

Rates data updated July 2026.

Facilitymedian $324 · 10th–90th $200$6610%20%10th90th$324Professionalmedian $224 · 10th–90th $107$6310%10%20%10th90th$224$100.0$500.0$2.0K$10.0K$50.0K

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

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$1,513.56
Median
$1,513.56
Typical High
$1,513.56
Aetna
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$213.80
Typical High
$630.96
BCBS
Setting
Facility
Modifier
Global
Typical Low
$64,565.42
Median
$75,857.76
Typical High
$91,201.08
BCBS
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$181.97
Typical High
$398.11
Cigna
Setting
Facility
Modifier
Global
Typical Low
$181.97
Median
$181.97
Typical High
$181.97
Cigna
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$302.00
Typical High
$602.56
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$389.05
Typical High
$489.78
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$389.05
Typical High
$489.78
Providence
Setting
Facility
Modifier
Global
Typical Low
$117.49
Median
$269.15
Typical High
$575.44
Providence
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$309.03
Typical High
$691.83
United
Setting
Facility
Modifier
Global
Typical Low
$309.03
Median
$309.03
Typical High
$309.03
United
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$331.13
Typical High
$575.44