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Utah rates for HCPCS 77063

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

Facilitymedian $83 · 10th–90th $33$890%20%10th90th$83Professionalmedian $56 · 10th–90th $26$1580%5%10%10th90th$56$20.0$50.0$100.0$200.0

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
$33.11 / $83.18 / $89.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $66.07 / $229.09
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$26.30 / $53.70 / $134.90
Aetna
Facility/Professional
Professional
Modifier
52
Typical Low / Median / Typical High
$26.92 / $57.54 / $281.84
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$20.89 / $27.54 / $141.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $72.44 / $109.65
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$30.20 / $39.81 / $61.66
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$24.55 / $31.62 / $48.98
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $57.54
Regence BlueShield
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$46.77 / $46.77 / $46.77
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $87.10 / $114.82
Regence BlueShield
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$38.90 / $46.77 / $64.57
Regence BlueShield
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$33.88 / $39.81 / $51.29
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $72.44 / $85.11
Select Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$26.92 / $44.67 / $50.12
Select Health
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$21.88 / $32.36 / $38.02
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $46.77 / $91.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $61.66 / $93.33
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$28.84 / $33.88 / $51.29
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$23.99 / $28.18 / $42.66