Diagnostic radiology · Montana

Diagnostic radiology commercial reimbursement in Montana

How Montana diagnostic radiology rates compare with the national market.

Diagnostic radiology in Montana

49 codes · 70 sampled providers
Index vs national
107
7% above
Rank among states
18 of 51
1 = highest
Codes above national
30 of 49
median code at 107%
Providers
70
sampled

What the data shows

1

Diagnostic radiology ranks 18th of 51 states in Montana with an index of 107 (100 = the specialty's national median), across 49 codes and 70 sampled providers.

2

Of the 49 diagnostic radiology codes with enough data in Montana, 30 pay above the national median and 19 below; the typical code sits at 107% of the national median.

3

Largest premium over the national median: CPT 99215 (Office o/p est hi 40 min) at 124%; largest discount: CPT 70551 (Mri brain stem w/o dye) at 79%.

4

Measured against Medicare, Montana diagnostic radiology rates have a median of 161% of the Medicare rate across these codes.

Codes above and below the national median

The five largest gaps in each direction

Highest vs national

CodeMontanaNationalGapProv.
99215
Office o/p est hi 40 min
$226$182+24%70
99212
Office o/p est sf 10 min
$60$50+19%70
99214
Office o/p est mod 30 min
$152$128+19%70
99204
Office o/p new mod 45 min
$220$187+18%70
99213
Office o/p est low 20 min
$103$88+17%70

Lowest vs national

CodeMontanaNationalGapProv.
70551
Mri brain stem w/o dye
$318$402-21%69
72148
Mri lumbar spine w/o dye
$310$392-21%69
72141
Mri neck spine w/o dye
$309$390-21%69
73721
Mri jnt of lwr extre w/o dye
$329$407-19%69
73221
Mri joint upr extrem w/o dye
$329$407-19%69

All diagnostic radiology codes in Montana

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
CodeMontanaNationalGap% of MedicareProvidersTINsLevel
CPT 99215
Office o/p est hi 40 min
$226$182+24%117%70157
CPT 99212
Office o/p est sf 10 min
$60$50+19%101%70159
CPT 99214
Office o/p est mod 30 min
$152$128+19%112%70158
CPT 99204
Office o/p new mod 45 min
$220$187+17%124%70158
CPT 99213
Office o/p est low 20 min
$103$88+17%108%70159
CPT 99203
Office o/p new low 30 min
$141$121+17%120%70159
CPT 20610
Drain/inj joint/bursa w/o us
$97$83+17%141%70160
CPT 99205
Office o/p new hi 60 min
$284$244+16%120%70156
CPT 73502
X-ray exam hip uni 2-3 views
$70$61+14%143%69157
CPT 76536
Us exam of head and neck
$174$154+13%160%69157
CPT 71046
X-ray exam chest 2 views
$51$45+12%153%69156
CPT 76641
Ultrasound breast complete
$162$145+12%162%69155
CPT 76642
Ultrasound breast limited
$134$120+11%161%69155
CPT 77066
Dx mammo incl cad bi
$250$225+11%159%69155
CPT 77065
Dx mammo incl cad uni
$198$179+11%160%69155
CPT 77067
Scr mammo bi incl cad
$200$182+10%158%69156
CPT 74177
Ct abd & pelvis w/contrast
$491$448+10%164%69155
CPT 76700
Us exam abdom complete
$184$168+9%161%69157
CPT 93970
Extremity study
$295$270+9%160%69156
CPT 93971
Extremity study
$188$172+9%161%69157
CPT 76705
Echo exam of abdomen
$137$126+9%159%69157
CPT 71045
X-ray exam chest 1 view
$36$33+8%140%69152
CPT 93880
Extracranial bilat study
$300$277+8%159%69157
CPT 76770
Us exam abdo back wall comp
$171$158+8%161%69157
CPT 71271
Ct thorax lung cancer scr c-
$222$208+7%163%69154
CPT 74178
Ct abd&plv wo cntr flwd cntr
$551$520+6%163%69155
CPT 93000
Electrocardiogram complete
$26$25+4%168%67125
CPT 74176
Ct abd & pelvis w/o contrast
$296$287+3%162%69155
CPT 74174
Cta abd&plvs w/contrast
$616$601+2%163%69155
CPT 37243
Vasc embolize/occlude organ
$877$858+2%182%69154
CPT 77049
Mri breast c-+ w/cad bi
$556$558-0%164%69153
CPT 71275
Ct angiography chest
$455$462-1%162%69157
CPT 70496
Ct angiography head
$446$457-2%163%69156
CPT 70498
Ct angiography neck
$446$459-3%163%69156
CPT 77080
Dxa bone density axial
$62$66-7%156%69156
CPT 70450
Ct head/brain w/o dye
$171$194-12%161%69157
CPT 72158
Mri lumbar spine w/o & w/dye
$518$593-13%163%69156
CPT 71260
Ct thorax dx c+
$270$312-13%162%69156
CPT 74183
Mri abd w/o cntr flwd cntr
$548$634-14%163%69157
CPT 72197
Mri pelvis w/o & w/dye
$546$634-14%163%69156
CPT 70553
Mri brain stem w/o & w/dye
$516$600-14%163%69156
CPT 71250
Ct thorax dx c-
$215$250-14%162%69157
CPT 72125
Ct neck spine w/o dye
$210$249-15%161%69156
CPT 72131
Ct lumbar spine w/o dye
$209$248-16%161%69156
CPT 73221
Mri joint upr extrem w/o dye
$329$407-19%160%69156
CPT 73721
Mri jnt of lwr extre w/o dye
$329$407-19%161%69156
CPT 72141
Mri neck spine w/o dye
$309$390-21%162%69156
CPT 72148
Mri lumbar spine w/o dye
$310$392-21%162%69157
CPT 70551
Mri brain stem w/o dye
$318$402-21%163%69156

Frequently asked questions

How do Montana diagnostic radiology rates compare with the rest of the country?

Montana ranks 18th of 51 states with an index of 107; 30 of 49 codes are above the national median.

Which diagnostic radiology code has the biggest premium in Montana?

CPT 99215 (Office o/p est hi 40 min), at 124% of the national median.

Are these Medicare or commercial rates?

Commercial in-network negotiated rates from four national payers' published files; the Medicare comparison column uses the CY2026 Medicare physician fee schedule.

Methodology

How these numbers are calculated
  • Source: in-network negotiated-rate files published under the federal Transparency in Coverage rule, August 2026 snapshot: UnitedHealthcare Choice plans (74 files); Aetna commercial plans (70 files); Cigna national PPO (1 files); BCBS licensees' own-network files (5,387 files). Payer comparisons describe these files, not each payer's entire book of business.
  • Sample: rates come from a random sample of up to 150 providers per state and specialty. Counts on this page are sampled providers and TINs, not totals.
  • Which providers count: only providers in a specialty relevant to the code, because a rate in a payer file attaches to a provider group and is listed under every provider in that group.
  • Filters: fee-for-service, professional billing class, no modifier, negotiated or fee-schedule dollar rates. Rates outside 1% to 1,000% of the Medicare rate are excluded.
  • Statistic: one median rate per provider, then percentiles across providers. A cell is shown only with at least 15 sampled providers and 4 TINs.
  • Medicare benchmark: CY2026 national physician fee schedule, non-QPP conversion factor, unadjusted for locality. Where the non-facility rate is more than twice the facility rate (office rates that include device or supply cost), the facility rate is used so comparisons are like for like.

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