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Montana rates for HCPCS 73201

Computed tomography, upper extremity; with contrast material(s)

Facilitymedian $85 · 10th–90th $85$1070%20%40%90th$85Professionalmedian $204 · 10th–90th $56$5010%5%10th90th$204$10.0$20.0$50.0$100.0$200.0$500.0$1.0K

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $338.84 / $870.96
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$51.29 / $89.13 / $245.47
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$158.49 / $275.42 / $501.19
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $85.11 / $323.59
Cigna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$85.11 / $85.11 / $107.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $323.59 / $588.84
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$38.02 / $85.11 / $151.36
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$158.49 / $239.88 / $436.52
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $371.54 / $575.44
Providence
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$85.11 / $85.11 / $107.15
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $457.09 / $562.34
Providence
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$56.23 / $85.11 / $125.89
Providence
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$162.18 / $239.88 / $363.08
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $251.19 / $446.68
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$50.12 / $51.29 / $125.89
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$141.25 / $199.53 / $354.81