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Montana rates for HCPCS 75557

Cardiac magnetic resonance imaging for morphology and function without contrast material;

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.00 / $478.63 / $1,584.89
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.82 / $169.82 / $446.68
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$169.82 / $169.82 / $213.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$295.12 / $549.54 / $851.14
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.78 / $512.86 / $724.44
Providence
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$169.82 / $169.82 / $213.80
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.87 / $645.65 / $794.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.42 / $389.05 / $602.56