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Internal Mammary Artery Dye X-Ray

Utah rates for HCPCS 75756

X-ray imaging of the internal mammary artery, the vessel running down the inside of the front of the chest, after a thin tube is guided into it and contrast dye is injected. It is most often done to check this artery before it is used as a bypass graft for the heart, or to check the graft afterwards.

Rates data updated October 2026.

How much does Internal Mammary Artery Dye X-Ray cost?

$120

Typical negotiated rate. In Utah, October 2026.

Insurers have agreed to pay about $120 for this service. The price depends on where it is billed: about $120 from a physician practice, and about $6,166 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 7 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$120$79.43 to $166
FacilityA hospital or hospital-owned outpatient department$6,166$263 to $8,318

How much rates vary

Facilitymedian $6,166 · 10th to 90th $263 to $10,715Professionalmedian $120 · 10th to 90th $35 to $257
$100$1K$10Kfacility $6,166professional $120

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$263.03
Median
$263.03
Typical High
$263.03
Aetna
Setting
Professional
Modifier
None (both parts)
Typical Low
$158.49
Median
$263.03
Typical High
$269.15
Aetna
Setting
Professional
Modifier
26 · Professional part
Typical Low
$53.70
Median
$72.44
Typical High
$72.44
Aetna
Setting
Professional
Modifier
TC · Technical part
Typical Low
$104.71
Median
$190.55
Typical High
$204.17
Cigna
Setting
Facility
Modifier
None
Typical Low
$3,467.37
Median
$5,495.41
Typical High
$25,118.86
Cigna
Setting
Professional
Modifier
None (both parts)
Typical Low
$186.21
Median
$257.04
Typical High
$323.59
Cigna
Setting
Professional
Modifier
26 · Professional part
Typical Low
$63.10
Median
$69.18
Typical High
$102.33
Cigna
Setting
Professional
Modifier
TC · Technical part
Typical Low
$123.03
Median
$186.21
Typical High
$223.87
Molina
Setting
Professional
Modifier
None (both parts)
Typical Low
$33.88
Median
$100.00
Typical High
$158.49
Regence BlueShield
Setting
Facility
Modifier
None
Typical Low
$5,248.07
Median
$6,760.83
Typical High
$10,715.19
Regence BlueShield
Setting
Professional
Modifier
None (both parts)
Typical Low
$229.09
Median
$263.03
Typical High
$338.84
Regence BlueShield
Setting
Professional
Modifier
26 · Professional part
Typical Low
$77.62
Median
$89.13
Typical High
$109.65
Regence BlueShield
Setting
Professional
Modifier
TC · Technical part
Typical Low
$151.36
Median
$177.83
Typical High
$223.87
Select Health
Setting
Facility
Modifier
None
Typical Low
$257.04
Median
$257.04
Typical High
$257.04
Select Health
Setting
Professional
Modifier
None (both parts)
Typical Low
$154.88
Median
$190.55
Typical High
$512.86
U of Utah Health Plan
Setting
Professional
Modifier
None
Typical Low
$64.57
Median
$154.88
Typical High
$363.08
United
Setting
Professional
Modifier
None (both parts)
Typical Low
$165.96
Median
$208.93
Typical High
$363.08
United
Setting
Professional
Modifier
26 · Professional part
Typical Low
$54.95
Median
$58.88
Typical High
$95.50
United
Setting
Professional
Modifier
TC · Technical part
Typical Low
$109.65
Median
$131.83
Typical High
$281.84
3 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$79.43
Median
$131.83
Typical High
$131.83
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$31.62
Median
$52.48
Typical High
$52.48
Aetna
Setting
Professional
Modifier
FX · Film X-ray
Typical Low
$128.82
Median
$208.93
Typical High
$208.93

Where Utah sits

The same service costs 4.0 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Utah· 50th of 51

$120

AK $479TX $120

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.