go back

Indiana rates for HCPCS 0633T

Computed tomography, breast, including 3D rendering, when performed, unilateral; without contrast material

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$196.57 / $631.00 / $2,040.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$182.36 / $203.12 / $245.75
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$394.00 / $839.50 / $2,256.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$171.64 / $214.55 / $296.07
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$193.53 / $2,013.84 / $4,875.66
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$76.00 / $122.27 / $700.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$250.00 / $283.20 / $373.77
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$94.85 / $114.82 / $199.68