Mammary ductogram (single duct X-ray)

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

HC MAMMARY DUCTOGRAM SINGLE

Payers reporting CPT 77053

Payer pricing summary

Low

$48

Average

$341

Median

$287

High

$878

Payer rate distribution

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#
1	Aetna fee schedule · outpatient · +35 other terms	573	$240	$288	$337	117%	3–30	$1 – $8.4k
2	UnitedHealthcare fee schedule · outpatient · +35 other terms	644	$325	$299	$295	99%	—	$1 – $7.1k
3	Cigna fee schedule · outpatient · +24 other terms	437	$247	$342	$275	80%	—	$17 – $1.2k
4	Blue Cross Blue Shield fee schedule · outpatient · +32 other terms	425	$330	$378	$336	89%	—	$1 – $1.8k
5	Humana fee schedule · outpatient · +28 other terms	339	$235	$207	$159	77%	—	$1 – $1.2k
6	Molina fee schedule · outpatient · +31 other terms	210	$209	$169	$147	87%	—	$1 – $957
7	Anthem fee schedule · outpatient · +25 other terms	146	$145	$137	$181	132%	—	$6 – $1.7k
8	WellCare fee schedule · outpatient · +19 other terms	139	$254	$250	$108	43%	—	$18 – $566
9	Ambetter facility · fee schedule · outpatient · +18 other terms	88	$407	$463	$702	152%	—	$75 – $7.1k
10	Kaiser fee schedule · outpatient · +21 other terms	84	$340	$382	$329	86%	—	$17 – $1.8k
11	MultiPlan fee schedule · outpatient · +21 other terms	73	$414	$438	$351	80%	—	$22 – $1.3k
12	Aetna Better Health fee schedule · outpatient · +18 other terms	71	$58	$77	$51	66%	—	$47 – $267
13	Devoted facility · fee schedule · outpatient · +11 other terms	61	$228	$301	$536	178%	—	$185 – $4.9k
14	Oscar fee schedule · outpatient · +19 other terms	58	$429	$311	$222	71%	—	$1 – $681
15	Caresource fee schedule · outpatient · +18 other terms	54	$235	$183	$107	59%	—	$1 – $580
16	Tricare fee schedule · outpatient · +18 other terms	50	$235	$224	$63	28%	—	$16 – $602
17	Optum fee schedule · outpatient · +17 other terms	49	$230	$296	$214	72%	—	$18 – $881
18	First Health fee schedule · outpatient · +17 other terms	43	$249	$199	$223	112%	—	$20 – $883
19	Highmark facility · fee schedule · outpatient · +14 other terms	39	$258	$243	$226	93%	—	$13 – $1.1k
20	Amerihealth Caritas facility · fee schedule · outpatient · +13 other terms	36	$70	$119	$104	87%	—	$44 – $536
21	Cigna Healthspring fee schedule · outpatient · +11 other terms	34	$191	$171	$91	53%	—	$54 – $300
22	Clover fee schedule · outpatient · +9 other terms	33	$264	$256	$18	7%	—	$215 – $288
23	Medicare fee schedule · outpatient · +15 other terms	28	$37	$110	$100	90%	—	$31 – $307
24	Superior Healthplan facility · fee schedule · outpatient · +7 other terms	28	$104	$106	$87	82%	—	$54 – $294
25	Medicaid facility · fee schedule · outpatient · +13 other terms	27	$118	$155	$129	83%	—	$31 – $448

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