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CT Scan Of One Breast, Without Contrast

Indiana 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 does CT Scan Of One Breast, Without Contrast cost?

$214

Typical negotiated rate. In Indiana, October 2026.

Insurers have agreed to pay about $214 for this service. The price depends on where it is billed: about $214 from a physician practice, and about $708 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$214$182 to $214
FacilityA hospital or hospital-owned outpatient department$708$316 to $1,148

How much rates vary

Facilitymedian $708 · 10th to 90th $214 to $2,089Professionalmedian $214 · 10th to 90th $112 to $288
$100$200$500$1K$2Kfacility $708professional $214

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
Facility
Modifier
None
Typical Low
$251.19
Median
$645.65
Typical High
$2,041.74
Aetna
Setting
Professional
Modifier
None (both parts)
Typical Low
$194.98
Median
$194.98
Typical High
$251.19
Aetna
Setting
Professional
Modifier
26 · Professional part
Typical Low
$72.44
Median
$75.86
Typical High
$93.33
Aetna
Setting
Professional
Modifier
TC · Technical part
Typical Low
$102.33
Median
$102.33
Typical High
$134.90
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$138.04
Median
$213.80
Typical High
$416.87
Anthem BCBS
Setting
Professional
Modifier
None (both parts)
Typical Low
$181.97
Median
$213.80
Typical High
$309.03
Anthem BCBS
Setting
Professional
Modifier
26 · Professional part
Typical Low
$61.66
Median
$91.20
Typical High
$181.97
Anthem BCBS
Setting
Professional
Modifier
TC · Technical part
Typical Low
$87.10
Median
$117.49
Typical High
$173.78
CareSource
Setting
Facility
Modifier
None
Typical Low
$194.98
Median
$1,778.28
Typical High
$4,365.16
Cigna
Setting
Facility
Modifier
None
Typical Low
$70.79
Median
$389.05
Typical High
$707.95
Cigna
Setting
Professional
Modifier
None (both parts)
Typical Low
$251.19
Median
$281.84
Typical High
$323.59
Physicians Health Plan of Northern Indiana
Setting
Facility
Modifier
None
Typical Low
$912.01
Median
$954.99
Typical High
$2,187.76
United
Setting
Professional
Modifier
None (both parts)
Typical Low
$95.50
Median
$117.49
Typical High
$213.80
United
Setting
Professional
Modifier
26 · Professional part
Typical Low
$61.66
Median
$93.33
Typical High
$141.25
United
Setting
Professional
Modifier
TC · Technical part
Typical Low
$85.11
Median
$109.65
Typical High
$204.17

Where Indiana sits

The same service costs 7.8 times more in Alaska than in Michigan. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Indiana· 22nd of 51

$214

AK $794MI $102

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.