Diagnostic radiology · Utah

Diagnostic radiology commercial reimbursement in Utah

How Utah diagnostic radiology rates compare with the national market.

Diagnostic radiology in Utah

49 codes · 122 sampled providers
Index vs national
94
6% below
Rank among states
33 of 51
1 = highest
Codes above national
11 of 49
median code at 94%
Providers
122
sampled

What the data shows

1

Diagnostic radiology ranks 33rd of 51 states in Utah with an index of 94 (100 = the specialty's national median), across 49 codes and 122 sampled providers.

2

Of the 49 diagnostic radiology codes with enough data in Utah, 11 pay above the national median and 38 below; the typical code sits at 94% of the national median.

3

Largest premium over the national median: CPT 76641 (Ultrasound breast complete) at 105%; largest discount: CPT 99212 (Office o/p est sf 10 min) at 82%.

4

Measured against Medicare, Utah diagnostic radiology rates have a median of 150% of the Medicare rate across these codes.

Codes above and below the national median

The five largest gaps in each direction

Highest vs national

CodeUtahNationalGapProv.
76641
Ultrasound breast complete
$153$145+5%122
76642
Ultrasound breast limited
$126$120+5%122
77066
Dx mammo incl cad bi
$236$225+5%121
77067
Scr mammo bi incl cad
$190$182+5%121
77065
Dx mammo incl cad uni
$186$179+4%121

Lowest vs national

CodeUtahNationalGapProv.
99212
Office o/p est sf 10 min
$42$50-18%122
99213
Office o/p est low 20 min
$77$88-13%121
76536
Us exam of head and neck
$136$154-12%121
70551
Mri brain stem w/o dye
$358$402-11%121
72148
Mri lumbar spine w/o dye
$349$392-11%121

All diagnostic radiology codes in Utah

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
CodeUtahNationalGap% of MedicareProvidersTINsLevel
CPT 76641
Ultrasound breast complete
$153$145+5%152%122305
CPT 76642
Ultrasound breast limited
$126$120+5%151%122305
CPT 77066
Dx mammo incl cad bi
$236$225+5%150%121304
CPT 77067
Scr mammo bi incl cad
$190$182+5%151%121302
CPT 77065
Dx mammo incl cad uni
$186$179+4%150%121304
CPT 77080
Dxa bone density axial
$68$66+3%173%121303
CPT 71275
Ct angiography chest
$468$462+1%167%121300
CPT 70498
Ct angiography neck
$464$459+1%169%121297
CPT 76700
Us exam abdom complete
$169$168+1%148%121304
CPT 70496
Ct angiography head
$459$457+0%167%121297
CPT 74174
Cta abd&plvs w/contrast
$603$601+0%159%121298
CPT 70450
Ct head/brain w/o dye
$193$194-1%181%121301
CPT 76770
Us exam abdo back wall comp
$157$158-1%148%121303
CPT 71260
Ct thorax dx c+
$304$312-3%182%121299
CPT 37243
Vasc embolize/occlude organ
$835$858-3%173%115298
CPT 72125
Ct neck spine w/o dye
$240$249-3%184%121296
CPT 71250
Ct thorax dx c-
$242$250-3%182%121300
CPT 93970
Extremity study
$260$270-4%141%121307
CPT 93880
Extracranial bilat study
$266$277-4%141%121301
CPT 99203
Office o/p new low 30 min
$116$121-4%98%121305
CPT 20610
Drain/inj joint/bursa w/o us
$79$83-4%115%122318
CPT 72131
Ct lumbar spine w/o dye
$235$248-5%181%121298
CPT 76705
Echo exam of abdomen
$119$126-6%138%121304
CPT 77049
Mri breast c-+ w/cad bi
$524$558-6%154%121302
CPT 71045
X-ray exam chest 1 view
$31$33-6%121%122303
CPT 99205
Office o/p new hi 60 min
$228$244-6%96%122306
CPT 71271
Ct thorax lung cancer scr c-
$194$208-7%143%121297
CPT 93971
Extremity study
$160$172-7%138%121304
CPT 73502
X-ray exam hip uni 2-3 views
$57$61-7%117%122307
CPT 99204
Office o/p new mod 45 min
$173$187-7%98%122308
CPT 74177
Ct abd & pelvis w/contrast
$412$448-8%137%121301
CPT 93000
Electrocardiogram complete
$23$25-8%149%121287
CPT 72158
Mri lumbar spine w/o & w/dye
$543$593-9%170%121303
CPT 74176
Ct abd & pelvis w/o contrast
$262$287-9%143%121297
CPT 71046
X-ray exam chest 2 views
$41$45-9%124%122306
CPT 99215
Office o/p est hi 40 min
$166$182-9%86%122305
CPT 73221
Mri joint upr extrem w/o dye
$370$407-9%180%121303
CPT 73721
Mri jnt of lwr extre w/o dye
$370$407-9%181%121301
CPT 74183
Mri abd w/o cntr flwd cntr
$574$634-9%171%121299
CPT 72197
Mri pelvis w/o & w/dye
$572$634-10%171%121299
CPT 70553
Mri brain stem w/o & w/dye
$541$600-10%171%121300
CPT 74178
Ct abd&plv wo cntr flwd cntr
$469$520-10%139%121299
CPT 99214
Office o/p est mod 30 min
$115$128-10%85%122309
CPT 72141
Mri neck spine w/o dye
$348$390-11%182%121301
CPT 72148
Mri lumbar spine w/o dye
$349$392-11%182%121302
CPT 70551
Mri brain stem w/o dye
$358$402-11%183%121302
CPT 76536
Us exam of head and neck
$136$154-12%125%121302
CPT 99213
Office o/p est low 20 min
$77$88-13%80%121306
CPT 99212
Office o/p est sf 10 min
$42$50-18%70%122303

Frequently asked questions

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

Utah ranks 33rd of 51 states with an index of 94; 11 of 49 codes are above the national median.

Which diagnostic radiology code has the biggest premium in Utah?

CPT 76641 (Ultrasound breast complete), at 105% 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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