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New Hampshire rates for HCPCS 77063

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

Facilitymedian $30 · 10th–90th $30$550%50%90th$30Professionalmedian $39 · 10th–90th $20$810%5%10th90th$39$10.0$20.0$50.0$100.0$200.0$500.0

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
26
Typical Low / Median / Typical High
$30.20 / $30.20 / $66.07
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $56.23 / $134.90
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$23.44 / $38.02 / $72.44
Aetna
Facility/Professional
Professional
Modifier
52
Typical Low / Median / Typical High
$22.91 / $41.69 / $81.28
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$19.05 / $26.92 / $60.26
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $53.70 / $123.03
Ambetter
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$22.39 / $32.36 / $57.54
Ambetter
Facility/Professional
Professional
Modifier
52
Typical Low / Median / Typical High
$10.47 / $10.47 / $10.47
Ambetter
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$27.54 / $27.54 / $27.54
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $51.29 / $69.18
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$21.38 / $27.54 / $38.02
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$18.20 / $23.44 / $31.62
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $83.18 / $151.36
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$31.62 / $48.98 / $79.43
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$23.44 / $41.69 / $70.79
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.88 / $42.66 / $70.79
Harvard Pilgrim
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$16.98 / $27.54 / $42.66
Harvard Pilgrim
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$13.80 / $21.88 / $34.67
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $69.18 / $141.25
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$17.78 / $37.15 / $74.13
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$15.49 / $31.62 / $67.61
Well Sense
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$21.38 / $23.44 / $27.54