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CT Scan Of One Breast, Without Contrast

Hawaii rates for HCPCS 0633T

A CT scan of one breast, taken without any contrast dye, with three-dimensional pictures built from the data when they are useful. It produces cross-sectional views through the whole breast rather than the flattened views a mammogram gives.

Rates data updated October 2026.

How much rates vary

Professionalmedian $347 · 10th to 90th $174 to $347
$100$200professional $347

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None (both parts)
Typical Low
$169.82
Median
$223.87
Typical High
$275.42
United
Setting
Professional
Modifier
None (both parts)
Typical Low
$190.55
Median
$346.74
Typical High
$346.74
United
Setting
Professional
Modifier
26 · Professional part
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
United
Setting
Professional
Modifier
TC · Technical part
Typical Low
$190.55
Median
$245.47
Typical High
$245.47