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Wisconsin rates for HCPCS 0634T

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

Facilitymedian $389 · 10th–90th $191–$9770%10%20%10th90th$389Professionalmedian $240 · 10th–90th $186–$6030%10%10th90th$240$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
$199.53 / $389.05 / $389.05
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $223.87 / $371.54
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $302.00 / $1,023.29
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $288.40 / $338.84
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $416.87 / $954.99
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $346.74 / $933.25
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $316.23 / $1,288.25
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $64.57 / $70.79
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $457.09 / $660.69
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$467.74 / $2,630.27 / $2,630.27
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $1,288.25 / $1,288.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $295.12 / $616.60
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $288.40 / $630.96