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Arkansas rates for HCPCS 77063

Screening digital breast tomosynthesis, bilateral (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$37.15 / $38.02 / $45.71
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.81 / $53.70 / $144.54
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$22.91 / $37.15 / $81.28
Aetna
Facility/Professional
Professional
Modifier
52
Low / Median / High Price
$23.99 / $44.67 / $95.50
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$16.98 / $25.12 / $54.95
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.88 / $42.66 / $75.86
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$21.38 / $28.18 / $44.67
Ambetter
Facility/Professional
Professional
Modifier
52
Low / Median / High Price
$9.77 / $75.86 / $79.43
Ambetter
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$17.38 / $29.51 / $34.67
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.86 / $75.86 / $75.86
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$43.65 / $43.65 / $43.65
BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$33.11 / $33.11 / $33.11
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.38 / $37.15 / $77.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.86 / $72.44 / $107.15
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$27.54 / $40.74 / $58.88
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$20.89 / $31.62 / $45.71
Qualchoice
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.88 / $87.10 / $89.13
Qualchoice
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$23.99 / $47.86 / $54.95
Qualchoice
Facility/Professional
Professional
Modifier
52
Low / Median / High Price
$87.10 / $87.10 / $91.20
Qualchoice
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$33.88 / $39.81 / $40.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.98 / $63.10 / $100.00
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$26.92 / $34.67 / $56.23
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$21.88 / $27.54 / $43.65