Diagnostic radiology · North Carolina

Diagnostic radiology commercial reimbursement in North Carolina

How North Carolina diagnostic radiology rates compare with the national market.

Diagnostic radiology in North Carolina

49 codes · 139 sampled providers
Index vs national
127
27% above
Rank among states
5 of 51
1 = highest
Codes above national
49 of 49
median code at 127%
Providers
139
sampled

What the data shows

1

Diagnostic radiology ranks 5th of 51 states in North Carolina with an index of 127 (100 = the specialty's national median), across 49 codes and 139 sampled providers.

2

Of the 49 diagnostic radiology codes with enough data in North Carolina, 49 pay above the national median and 0 below; the typical code sits at 127% of the national median.

3

Largest premium over the national median: CPT 74183 (Mri abd w/o cntr flwd cntr) at 152%; largest discount: CPT 99213 (Office o/p est low 20 min) at 112%.

4

Measured against Medicare, North Carolina diagnostic radiology rates have a median of 198% of the Medicare rate across these codes.

Codes above and below the national median

The five largest gaps in each direction

Highest vs national

CodeNorth CaroNationalGapProv.
74183
Mri abd w/o cntr flwd cntr
$967$634+52%124
72197
Mri pelvis w/o & w/dye
$953$634+50%123
77080
Dxa bone density axial
$94$66+42%124
71250
Ct thorax dx c-
$351$250+40%124
72125
Ct neck spine w/o dye
$348$249+40%124

Lowest vs national

CodeNorth CaroNationalGapProv.
99213
Office o/p est low 20 min
$98$88+12%139
71045
X-ray exam chest 1 view
$37$33+14%120
76536
Us exam of head and neck
$177$154+14%124
99215
Office o/p est hi 40 min
$211$182+16%138
99212
Office o/p est sf 10 min
$59$50+18%139

All diagnostic radiology codes in North Carolina

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
CodeNorth CaroliNationalGap% of MedicareProvidersTINsLevel
CPT 74183
Mri abd w/o cntr flwd cntr
$967$634+52%288%124365
CPT 72197
Mri pelvis w/o & w/dye
$953$634+50%285%123366
CPT 77080
Dxa bone density axial
$94$66+42%239%124366
CPT 71250
Ct thorax dx c-
$351$250+40%265%124365
CPT 72125
Ct neck spine w/o dye
$348$249+40%266%124366
CPT 72131
Ct lumbar spine w/o dye
$345$248+39%266%124366
CPT 71260
Ct thorax dx c+
$419$312+34%252%124365
CPT 71271
Ct thorax lung cancer scr c-
$276$208+33%202%121371
CPT 70450
Ct head/brain w/o dye
$257$194+32%241%124367
CPT 71275
Ct angiography chest
$610$462+32%217%124369
CPT 70496
Ct angiography head
$602$457+32%220%124365
CPT 72148
Mri lumbar spine w/o dye
$516$392+32%269%124364
CPT 70498
Ct angiography neck
$603$459+32%220%124363
CPT 20610
Drain/inj joint/bursa w/o us
$109$83+31%158%139499
CPT 70553
Mri brain stem w/o & w/dye
$785$600+31%248%124365
CPT 74176
Ct abd & pelvis w/o contrast
$375$287+31%205%121364
CPT 72158
Mri lumbar spine w/o & w/dye
$774$593+31%243%124365
CPT 37243
Vasc embolize/occlude organ
$1,120$858+31%232%123449
CPT 93971
Extremity study
$224$172+30%193%124378
CPT 77049
Mri breast c-+ w/cad bi
$723$558+30%213%121369
CPT 72141
Mri neck spine w/o dye
$504$390+29%265%124366
CPT 70551
Mri brain stem w/o dye
$520$402+29%266%124365
CPT 74178
Ct abd&plv wo cntr flwd cntr
$671$520+29%198%121363
CPT 93970
Extremity study
$345$270+28%187%124377
CPT 73721
Mri jnt of lwr extre w/o dye
$517$407+27%253%124367
CPT 73221
Mri joint upr extrem w/o dye
$517$407+27%252%124367
CPT 93000
Electrocardiogram complete
$32$25+27%206%124355
CPT 93880
Extracranial bilat study
$350$277+26%185%124366
CPT 74177
Ct abd & pelvis w/contrast
$565$448+26%188%121367
CPT 74174
Cta abd&plvs w/contrast
$751$601+25%198%121364
CPT 76770
Us exam abdo back wall comp
$196$158+24%184%124368
CPT 99205
Office o/p new hi 60 min
$301$244+23%127%138490
CPT 99204
Office o/p new mod 45 min
$231$187+23%130%139489
CPT 76641
Ultrasound breast complete
$178$145+22%177%121367
CPT 76642
Ultrasound breast limited
$146$120+22%175%121366
CPT 71046
X-ray exam chest 2 views
$55$45+22%166%120364
CPT 99203
Office o/p new low 30 min
$147$121+22%125%139489
CPT 76700
Us exam abdom complete
$203$168+21%178%124370
CPT 77067
Scr mammo bi incl cad
$219$182+21%174%121366
CPT 77065
Dx mammo incl cad uni
$215$179+20%173%121364
CPT 77066
Dx mammo incl cad bi
$271$225+20%172%121372
CPT 76705
Echo exam of abdomen
$151$126+20%175%124369
CPT 73502
X-ray exam hip uni 2-3 views
$74$61+20%151%121366
CPT 99214
Office o/p est mod 30 min
$151$128+18%111%139489
CPT 99212
Office o/p est sf 10 min
$59$50+18%100%139488
CPT 99215
Office o/p est hi 40 min
$211$182+16%110%138485
CPT 76536
Us exam of head and neck
$177$154+14%163%124368
CPT 71045
X-ray exam chest 1 view
$37$33+14%147%120359
CPT 99213
Office o/p est low 20 min
$98$88+12%103%139489

Frequently asked questions

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

North Carolina ranks 5th of 51 states with an index of 127; 49 of 49 codes are above the national median.

Which diagnostic radiology code has the biggest premium in North Carolina?

CPT 74183 (Mri abd w/o cntr flwd cntr), at 152% 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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