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Utah rates for HCPCS 0634T

Computed tomography, breast, including 3D rendering, when performed, unilateral; with contrast material(s)

Facilitymedian $2,188 · 10th–90th $219–$2,8840%20%10th90th$2,188Professionalmedian $219 · 10th–90th $155–$2750%10%20%10th90th$219$50.0$100.0$200.0$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $2,187.76 / $2,884.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $218.78 / $275.42
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$407.38 / $489.78 / $602.56
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $371.54 / $416.87
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $60.26
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $363.08 / $724.44
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $229.09 / $295.12
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $234.42 / $251.19
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $173.78 / $269.15
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $154.88 / $309.03