Diagnostic mammogram of one breast with computer-aided detection

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 DX MAMMO INCL CAD UNI

Payers reporting HCPCS G0206

Payer pricing summary

Low

$31

Average

$259

Median

$225

High

$635

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	Cigna fee schedule · outpatient · +15 other terms	36	$226	$225	$82	36%	—	$116 – $466
2	Blue Cross Blue Shield fee schedule · outpatient · +9 other terms	35	$374	$360	$100	28%	—	$53 – $518
3	Aetna fee schedule · outpatient · +13 other terms	34	$182	$297	$233	79%	—	$86 – $942
4	Anthem fee schedule · outpatient · +9 other terms	11	$169	$148	$43	29%	—	$87 – $193
5	MultiPlan per diem · outpatient · +7 other terms	7	$240	$239	$4	2%	—	$235 – $244
6	UnitedHealthcare facility · fee schedule · outpatient · +16 other terms	7	$158	$210	$113	54%	—	$20 – $447
7	Humana fee schedule · outpatient · +11 other terms	6	$86	$108	$27	25%	—	$86 – $150
8	Kaiser per diem · outpatient · +6 other terms	4	$174	$176	$17	9%	—	$155 – $198
9	WellCare fee schedule · outpatient · +3 other terms	4	$88	$88	—	—	—	$88 – $88
10	Ambetter professional · percent of total billed charges · inpatientfrom % of charges · +1 other terms	3	$176	$176	—	—	—	$176 – $176
11	Medcost professional · percent of total billed charges · inpatientfrom % of charges · +1 other terms	3	$470	$470	—	—	—	$470 – $470
12	Molina facility · fee schedule · outpatient · +4 other terms	3	$20	$138	$98	71%	—	$20 – $235
13	Phcs professional · percent of total billed charges · inpatientfrom % of charges · +3 other terms	3	$517	$517	—	—	—	$517 – $517
14	Tricare facility · percent of total billed charges · outpatientfrom % of charges	3	$74	$75	$1	1%	—	$74 – $76
15	Bcbs Ks percent of total billed charges · outpatientfrom % of charges	2	$198	$198	$8	4%	—	$186 – $204
16	Magellan facility · percent of total billed charges · outpatientfrom % of charges · +1 other terms	2	$635	$613	$64	10%	—	$568 – $703
17	Medicaid case rate · both · +3 other terms	2	$133	$133	$15	12%	—	$118 – $149
18	Aetna Better Health facility · case rate · outpatient · +1 other terms	1	$34	$34	$0	1%	—	$34 – $35
19	Amerihealth Caritas facility · case rate · outpatient	1	$35	$35	—	—	—	$35 – $35
20	Bcbs Ca facility · other · outpatient · +2 other terms	1	$633	$633	$88	14%	—	$501 – $776
21	Bcbs Tx percent of total billed charges · outpatientfrom % of charges	1	$59	$59	$7	11%	—	$52 – $65
22	Caresource fee schedule · outpatient	1	$152	$152	—	—	—	$152 – $152
23	Devoted facility · other · outpatient · +2 other terms	1	$281	$281	—	—	—	$281 – $281
24	Excellus facility · fee schedule · outpatient	1	$412	$412	$49	12%	—	$343 – $447
25	First Health facility · other · outpatient · +6 other terms	1	$328	$328	$39	12%	—	$273 – $356

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