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See a sample rate comparisonCPT 76498 Fee Schedule
CPT 76498 is classified under Radiology Procedures, in the Diagnostic Radiology (Diagnostic Imaging) Procedures subgroup.
Mri Scan, An Mri (Magnetic Resonance Imaging) Uses A Strong Magnetic Field To View An Area Of The Body. 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 | 26 - Professional component TC - Technical component |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 76498 |
| Medicaid Fee Schedule | $87.53 median of the 5 states in the free preview · View Medicaid rates for 76498 |
National average reimbursement for CPT 76498 by major payers:
$284.66
BCBS / Anthem
$309.99
UnitedHealthcare
$317.71
Aetna
$202.76
Cigna
Compare published rates across providers.
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CPT 76498
5 of 25 sample ratesHigher to lower in this preview
Prisma Health-Upstate, Prisma Health Transplant Center
Prisma Health - Upstate
$401.86Published rateMadison Hma LLC, Merit Health Madison
Madison Hma LLC
$159.61Published rateWhite River Health System, Inc., White River Medical Center
White River Health System Inc
$106.63Published rateCoastal Carolina Medical Center, Inc., Coastal Carolina Hospital
$80.90Published rateMercy Health Kings Mills Hospital LLC, Mercy Health - Kings Mills Hospital
Mercy Health Kings Mills Hospital LLC
$66.55Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 76498 vs. Other Diagnostic Radiology (Diagnostic Imaging) Procedures Codes
The table lists codes related to 76498. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 76498-CPT | Moderate | Mri Scan, An Mri (Magnetic Resonance Imaging) Uses A Strong Magnetic Field To View An Area Of The Body. Multiple Images May Be Taken. |
| 76499-CPT | High | Unlisted Diagnostic Radiologic Procedure |
| 76700-CPT | Low | Ultrasound Abdominal |
| 76870-CPT | Low | Ultrasound Of Scrotum, An Ultrasound (Sound Waves) To Create An Image Of The Interior Of The Scrotum. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 76498. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 76498 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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Frequently Asked Questions
To find out the estimated cost of a medical procedure, you can contact your healthcare provider's billing department for an estimate. For a more detailed understanding and to compare prices, especially across different providers or locations, you can use online tools. Payerprice offers a fee schedule lookup tool where you can search with specific CPT codes and locations to get an idea of costs. Additionally, contacting your health insurance company directly is crucial to understand your benefits, deductibles, co-pays, and out-of-pocket maximums for the specific procedure.
A CPT (Current Procedural Terminology) code is a standardized five-digit code used by healthcare providers to describe medical, surgical, and diagnostic services. These codes are vital for consistent communication between doctors, patients, and insurance companies, ensuring accurate billing and payment for healthcare services. Knowing the CPT code for a procedure can help you research its cost and verify that you are being billed correctly.
No, typically health insurance does not cover all healthcare costs. Most insurance plans involve various out-of-pocket expenses such as deductibles (the amount you pay before your insurance starts covering costs), co-pays (a fixed amount you pay for a healthcare service), and co-insurance (a percentage of the cost of a service you pay after you've met your deductible). There are also out-of-pocket maximums, which limit the total amount you'll have to pay in a policy year. It's essential to review your specific insurance policy documents or contact your insurer directly to understand your coverage and financial responsibilities.
If you receive an unexpected medical bill, it's important to carefully review it for accuracy. Compare the dates, services rendered, and CPT codes with your medical records or the Explanation of Benefits (EOB) from your insurer. If you find discrepancies or don't understand the charges, contact the healthcare provider's billing department for clarification. Also, reach out to your insurance company to ensure the claim was processed correctly according to your plan benefits. If the issue remains unresolved, you may be able to negotiate the bill or seek assistance from patient advocacy groups.
To compare prices for medical services, you have several options. Many health insurance companies offer tools on their websites to compare costs for in-network providers. For a more independent search, especially to look up specific procedure costs by CPT code and location, consider using platforms like Payerprice. Their fee schedule lookup tool can provide valuable insights into what different providers charge for the same service, enabling you to make more informed decisions about your healthcare.