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Washington rates for HCPCS 0634T

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

Facilitymedian $398 · 10th–90th $162–$8130%10%20%10th90th$398Professionalmedian $224 · 10th–90th $170–$4070%10%10th90th$224$50.0$100.0$200.0$500.0$1.0K

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
$223.87 / $223.87 / $223.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $218.78 / $275.42
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $512.86 / $1,000.00
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $389.05 / $549.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $524.81 / $851.14
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $537.03 / $891.25
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $933.25 / $933.25
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $50.12 / $70.79
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $398.11 / $398.11
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $275.42
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $389.05 / $588.84
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$380.19 / $512.86 / $1,000.00
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $389.05 / $524.81
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $549.54 / $1,000.00
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $194.98 / $467.74