What Imaging Actually Costs in Montana
Ask what a scan costs in Montana and the honest answer is that it depends more than it should. The same study, ordered for the same reason, can carry prices that differ by a factor of three or four depending only on which building it happens in. That is not a rumor. It is visible in the price files providers are required to publish, and it is worth understanding before you schedule anything.
The range is bigger than people expect
Take a brain MRI as the example, because it is the study with the most published data in Montana. Reading self-pay prices off Montana providers' own published files and pricing pages, the figures run from roughly the high six hundreds at a small critical access hospital to over two and a half thousand dollars at a large clinic. Same study. Same state.
The pattern that surprises people is which end is which. The assumption is usually that a big hospital is expensive and an independent imaging center is the bargain. In Montana that does not reliably hold. Some of the lowest published self-pay prices sit at small rural hospitals, and some independents price in the middle. The useful conclusion is not that one category is cheaper. It is that the spread is wide enough that asking is worth real money.
What almost nobody publishes at all
There is a second problem underneath the first. For several common studies, no Montana provider publishes a cash price you can look up. Screening mammography, general diagnostic ultrasound, and CT all fall into this category. Aggregator sites will show a Montana state average for them, but with no actual Montana facility standing behind the number, which makes it an estimate dressed as a price.
So for those studies the published-price route is usually a dead end, and the fallback is calling the facility and asking for the self-pay rate directly. That is a less satisfying answer than a table.
Which is the reason we now publish ours. Our 2026 ultrasound price list gives a cash price for all 43 ultrasound, echo and vascular studies we perform, by CPT code, and it is on this website rather than buried in a spreadsheet. An abdominal complete is $377.31. A pelvic is $338.27. A bilateral carotid duplex is $631.02. The range across the whole list runs from $170.03 to $806.65.
We are not claiming those are the lowest numbers in the state, because we have not seen everyone else's and neither has anyone else. We are claiming they are knowable, which for diagnostic ultrasound in Montana is not a small thing.
How to get a real number
Three things work, in order of effort. Ask the ordering provider's office first, because schedulers often know the local landscape and can say which nearby facility is cheaper. Ask the facility directly for its self-pay or cash price, using those words, and ask whether it must be paid in advance to get that rate. Many discounted rates are conditional on prepayment. Last, check the hospital's price transparency file, which every hospital is required to publish, though they are awkward documents to read.
If you carry insurance, still ask. A cash price is sometimes lower than what a patient with a high deductible ends up paying, and you are allowed to ask for both numbers before deciding.
One caution about any figure you find
Published prices go stale. Some of the pricing pages available in Montana have not been updated in over a year, and a price file is a snapshot of a policy rather than a quote. Whatever number you find, including the ranges above, confirm it by phone before you rely on it. We are describing a market, not quoting anyone.
How Big Sky handles the money side
For ultrasound we publish the number outright, on a page you can read without calling anyone: what an ultrasound costs with us, all 43 studies, by CPT code.
One detail in that list matters more than the numbers themselves. Each price includes the radiologist's reading fee. In a lot of imaging the scan and the interpretation are billed separately, which is how a patient who thought they had paid gets a second invoice weeks later from a radiology group they have never heard of. That does not happen here, and it is the single most common way a quoted imaging price turns out to be incomplete. When you are calling around for numbers, it is the question worth asking every time: does that include the read?
Cash pay is accepted, and Medicare and Medicaid are accepted as well. There is no attempt here to steer anyone toward one door or the other. A provider order is required regardless, and once it is in, our team schedules the visit and dispatches a technician in your region or sees the patient at a regional clinic. If you want to understand the cost side before scheduling, call and ask. We would rather have that conversation up front than have a patient delay a study they need because the money was unclear.