How do Medicare & Medicaid Rates affect fee schedules?

Medicare & Medicaid Rates are government-set reimbursement amounts.

How do Private Insurance Rates affect fee schedules?

Private Insurance Rates are negotiated rates between providers and insurance companies.

CPT stands for Current Procedural Terminology. CPT codes are a set of medical codes used by physicians, allied health professionals, and other healthcare providers to report medical, surgical, and diagnostic services and procedures to entities such as insurance companies. They are essential for accurate billing and record-keeping in healthcare.

How can I find the cost of a medical procedure?

To find the cost of a specific medical procedure, especially one identified by a CPT code, you can use specialized tools that provide fee schedule lookups. For a comprehensive and specific search, it's recommended to use platforms like Payerprice. Payerprice offers a fee schedule lookup tool where you can input the CPT code and your specific location to get relevant pricing information.

Payerprice is a platform that provides a fee schedule lookup tool designed to help users find the cost of medical procedures. It allows users to search for pricing information based on CPT codes and specific geographical locations, offering transparency in healthcare costs.

How is Payerprice different from CMS for pricing information?

While CMS (Centers for Medicare & Medicaid Services) provides extensive data on Medicare reimbursement rates, Payerprice offers a broader fee schedule lookup tool that can provide more general or commercial pricing information relevant to various payers and specific locations. Payerprice's tool is designed for users to search directly with CPT codes and specific locations, which can be more useful for understanding a wider range of healthcare costs beyond just Medicare rates.

Why should I use Payerprice for fee schedule lookup?

You should use Payerprice for fee schedule lookup because it provides a user-friendly tool to search for specific medical procedure costs. Its ability to filter by CPT code and specific location allows for highly relevant and localized pricing information, which can be crucial for patients, providers, and others seeking to understand healthcare expenses.

Can I find prices for specific locations using Payerprice?

Yes, Payerprice's fee schedule lookup tool is specifically designed to allow users to search for pricing information based on both the CPT code and their specific location, ensuring that the retrieved cost data is relevant to their geographical area.

CPT 70543 Fee Schedule

Last Verified: September 2026

Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.

Mri Of The Face And Neck, Mri (Magnetic Resonance Imaging) Uses A Strong Magnetic Field To View And Create Images Of The Eyes Face And Neck. A Contrast Agent May Be Introduced To Highlight Areas. Multiple Images May Be Taken.

Key Fact	Detail
Service Type	Radiology Procedures Diagnostic Radiology (Diagnostic Imaging) Procedures
Common Place of Service	11 - Office 22 - On Campus Outpatient Hospital
Common Modifiers	None 26 - Professional component TC - Technical component
Complexity Level	Moderate
Medicare Fee Schedule	View Medicare rates for 70543
Medicaid Fee Schedule	View Medicaid rates for 70543

National average reimbursement for CPT 70543 by major payers:

$456.82

$634.12

$632.64

$693.38

Compare published rates across providers.

Choose a payer to see a sample of rates for CPT 70543.

CPT 70543

5 of 25 sample ratesHigher to lower in this preview

Adventhealth Polk South Inc, Adventhealth Lake Wales
FLGeneral Acute Care HospitalNPI 1053972760Tax ID 83-4672945
$958.38Published rate
Surgical Specialty Center Of Baton Rouge, LLC, Surgical Specialty Center Of Baton Rouge
Surgical Specialty Center Of Baton Rouge, LLC
LAGeneral Acute Care HospitalNPI 1588631311Tax ID 26-3120962
$828.27Published rate
Texarkana Pet/Ct Imaging Institute, L.P.
Texarkana Petct Imaging Institute Lp
TXRadiology Clinic/CenterNPI 1053334441Tax ID 72-1513569
$732.66Published rate
Emerus Bhs Sa Thousand Oaks LLC
TXGeneral Acute Care HospitalNPI 1275235426Tax ID 45-2497248
$368.11Published rate
St Elizabeth Southwoods Imaging LLC, Southwoods Imaging Center
St Elizabeth Southwoods Imaging LLC
OHRadiology Clinic/CenterNPI 1477731073Tax ID 26-1626482
$88.63Published rate

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Summit Women's CareDenver, Colorado

September 2, 2026

Contracting Manager
UnitedHealthcare
Commercial PPO

Re: Request for fee schedule renegotiation

We request a formal review of our Commercial PPO fee schedule. The comparison below summarizes our current rate alongside published rates for comparable Denver-area practices.

Market evidence · CPT 59485

Current rate: $152.40
Market median: $147.00
Market position: 61st percentile

The comparison includes 1,284 published rates from 96 provider groups, scoped to OB/GYN providers in a professional, office-based setting.

We would welcome a discussion of our fee schedule and the supporting July 2026 market analysis. Please let us know a suitable time to review the comparison together.

Sincerely,
Summit Women's Care

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CPT 70543 vs. Other Diagnostic Radiology (Diagnostic Imaging) Procedures Codes

The CPT 70543 code is part of the Radiology Procedures services used for Diagnostic Radiology (Diagnostic Imaging) Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.

The CPT 70543 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.

Code	Complexity	Description
70492-CPT	Moderate	Ct Scan Of Neck, A Ct Scanner Circles The Head Taking X-Rays Of The Neck And Assembles Them Into A 3-D Image. Dye (Contrast) May Be Used To Make The Area Easier To See.
70540-CPT	Moderate	Mri Of The Face And Neck, Mri (Magnetic Resonance Imaging) Uses A Strong Magnetic Field To View And Create Images Of The Eyes Face And Neck. A Contrast Agent May Be Introduced To Highlight Areas. Multiple Images May Be Taken.
70542-CPT	Moderate	Mri Of The Face And Neck, Mri (Magnetic Resonance Imaging) Uses A Strong Magnetic Field To View And Create Images Of The Eyes Face And Neck. A Contrast Agent May Be Introduced To Highlight Areas. Multiple Images May Be Taken.
70543-CPT	Moderate	Mri Of The Face And Neck, Mri (Magnetic Resonance Imaging) Uses A Strong Magnetic Field To View And Create Images Of The Eyes Face And Neck. A Contrast Agent May Be Introduced To Highlight Areas. Multiple Images May Be Taken.

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 70543. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 70543 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.

Factors that affect fee schedules

Medicare & Medicaid Rates

Government-set reimbursement amounts

Private Insurance Rates

Negotiated rates between providers and insurance companies

Geographic Location

Costs may be higher in urban areas.

Provider Type

Hospital providers may have different rates than private practice.

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CPT 70543 Fee Schedule

Compare published rates across providers.

Adventhealth Polk South Inc, Adventhealth Lake Wales

Surgical Specialty Center Of Baton Rouge, LLC, Surgical Specialty Center Of Baton Rouge

Texarkana Pet/Ct Imaging Institute, L.P.

Emerus Bhs Sa Thousand Oaks LLC

St Elizabeth Southwoods Imaging LLC, Southwoods Imaging Center