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California rates for HCPCS 77063

Screening Digital Breast Tomosynthesis Bi

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$25.32 / $33.47 / $136.66
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.14 / $63.56 / $259.64
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$26.57 / $32.86 / $134.44
Aetna
Facility/Professional
Professional
Modifier
52
Low / Median / High Price
$47.78 / $143.19 / $285.00
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$22.46 / $27.35 / $141.00
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.49 / $55.33 / $139.15
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$21.51 / $32.33 / $64.36
Ambetter
Facility/Professional
Professional
Modifier
52
Low / Median / High Price
$22.88 / $33.88 / $43.40
Ambetter
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$21.02 / $37.27 / $50.10
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.14 / $100.64 / $176.62
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$31.12 / $52.07 / $94.07
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$25.47 / $49.52 / $86.83
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.19 / $68.50 / $155.77
Blue Shield
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$27.49 / $34.86 / $94.20
Blue Shield
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$25.93 / $32.96 / $83.45
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$32.40 / $32.40 / $32.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.77 / $69.79 / $152.02
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$25.18 / $37.61 / $80.68
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$22.18 / $33.34 / $74.20
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.52 / $64.69 / $87.33
Contra Costa Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$25.19 / $31.65 / $42.73
Contra Costa Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$22.33 / $33.04 / $44.62
HealthNet
Facility/Professional
Professional
Modifier
Low / Median / High Price
$195.75 / $236.41 / $452.20
HealthNet
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$66.70 / $114.60 / $164.44
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.18 / $64.69 / $111.52
Kaiser Permanente
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$28.00 / $37.97 / $59.50
Kaiser Permanente
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$26.44 / $38.19 / $61.92
Lucent Health
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$85.00 / $139.60 / $139.60
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$334.42 / $334.42 / $432.98
Lucent Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$182.49 / $182.49 / $229.28
Lucent Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$151.88 / $151.88 / $203.70
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $34.36
Providence
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$32.40 / $32.40 / $32.40
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.17 / $76.84 / $148.19
Providence
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$25.40 / $36.89 / $79.22
Providence
Facility/Professional
Professional
Modifier
52
Low / Median / High Price
$60.41 / $60.41 / $60.41
Providence
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$22.34 / $33.09 / $74.20
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.65 / $181.65 / $181.65
Sutter Health Plus
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$97.50 / $97.50 / $97.50
Sutter Health Plus
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$84.15 / $84.15 / $84.15
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.31 / $66.53 / $80.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.62 / $62.47 / $161.78
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$24.15 / $33.75 / $85.36
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$20.47 / $27.96 / $71.18