go back

Michigan 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
$125.89 / $245.47 / $245.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.82 / $218.78 / $275.42
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.72 / $97.72 / $100.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.50 / $100.00 / $102.33
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$309.03 / $309.03 / $309.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $251.19 / $933.25
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$245.47 / $245.47 / $245.47
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.97 / $229.09 / $316.23
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$309.03 / $309.03 / $309.03
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $251.19 / $933.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.18 / $107.15 / $275.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.33 / $112.20 / $165.96