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Wisconsin rates for HCPCS 77063

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

Facilitymedian $60 · 10th–90th $30$1200%20%10th90th$60Professionalmedian $63 · 10th–90th $27$1660%5%10th90th$63$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
$26.92 / $42.66 / $60.26
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $83.18 / $208.93
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$26.92 / $58.88 / $147.91
Aetna
Facility/Professional
Professional
Modifier
52
Typical Low / Median / Typical High
$22.39 / $48.98 / $114.82
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$19.95 / $40.74 / $123.03
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $74.13 / $239.88
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$27.54 / $42.66 / $131.83
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$22.91 / $36.31 / $107.15
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $36.31 / $66.07
Cigna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$79.43 / $89.13 / $138.04
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $125.89 / $213.80
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$33.11 / $67.61 / $114.82
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$27.54 / $58.88 / $97.72
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $114.82 / $158.49
DeanCare
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$52.48 / $63.10 / $85.11
DeanCare
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$44.67 / $52.48 / $72.44
Medica
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$31.62 / $128.82 / $128.82
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $100.00 / $331.13
Medica
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$33.88 / $56.23 / $147.91
Medica
Facility/Professional
Professional
Modifier
52
Typical Low / Median / Typical High
$41.69 / $72.44 / $74.13
Medica
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$26.30 / $43.65 / $151.36
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $74.13
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $134.90 / $194.98
Network Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$40.74 / $72.44 / $107.15
Network Health
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$34.67 / $61.66 / $87.10
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $120.23 / $181.97
Quartz
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$66.07 / $181.97 / $181.97
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $269.15 / $331.13
Quartz
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$35.48 / $147.91 / $181.97
Quartz
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$30.90 / $120.23 / $151.36
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $134.90
Security Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$75.86 / $75.86 / $75.86
Security Health
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$60.26 / $60.26 / $60.26
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $147.91 / $331.13
Security Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$61.66 / $72.44 / $102.33
Security Health
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$50.12 / $58.88 / $85.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $131.83 / $398.11
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$51.29 / $95.50 / $186.21
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$41.69 / $95.50 / $151.36