RC 403

Screening mammogram

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

Screening mammography

Payers reporting RC 403

Payer pricing summary

Low

$65

Average

$305

Median

$206

High

$2.3k

Payer rate distribution

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#
1	Bcbs Al facility · other · outpatient · +3 other terms	6	$68	$83	$32	38%	32,002–32,038	$33 – $119
2	Anthem fee schedule · outpatient · +29 other terms	127	$120	$135	$133	99%	30,212–30,473	$9 – $967
3	UnitedHealthcare fee schedule · outpatient · +34 other terms	510	$172	$189	$191	101%	4,083–4,326	$1 – $2.3k
4	Cigna fee schedule · outpatient · +29 other terms	211	$175	$686	$1.3k	187%	3,459–3,549	$11 – $16.8k
5	Aetna fee schedule · outpatient · +31 other terms	272	$130	$335	$627	187%	3,431–3,602	$1 – $19.3k
6	Humana fee schedule · outpatient · +26 other terms	191	$80	$396	$444	112%	1,886–1,949	$1 – $3.2k
7	Ucare fee schedule · outpatient · +14 other terms	12	$142	$154	$113	73%	1,842	$37 – $676
8	Medica fee schedule · outpatient · +18 other terms	41	$195	$208	$148	71%	1,493–1,511	$13 – $974
9	WellCare fee schedule · outpatient · +20 other terms	99	$70	$78	$45	58%	1,425–1,515	$11 – $259
10	Molina fee schedule · outpatient · +28 other terms	93	$73	$93	$73	78%	1,139–1,211	$1 – $398
11	Ambetter fee schedule · both · +17 other terms	69	$117	$129	$90	70%	220	$19 – $399
12	Sanford Health Plan fee schedule · outpatient · +10 other terms	24	$258	$211	$200	95%	82–100	$50 – $885
13	Bcbs Sc percent of total billed charges · bothfrom % of charges	1	$66	$66	$51	76%	46	$16 – $117
14	Caresource fee schedule · outpatient · +16 other terms	41	$91	$168	$147	87%	12–120	$1 – $2.6k
15	Premera facility · fee schedule · both · +8 other terms	29	$112	$147	$154	104%	10–100	$28 – $922
16	Wellmark facility · fee schedule · both · +14 other terms	41	$91	$133	$140	105%	7–70	$19 – $922
17	Excellus facility · fee schedule · both · +8 other terms	29	$108	$130	$145	111%	5–50	$10 – $922
18	Carefirst facility · fee schedule · both · +9 other terms	28	$112	$150	$157	105%	5–50	$28 – $922
19	Bcbs Mo professional · other · both · +2 other terms	1	$295	$295	—	—	1–10	$295 – $295
20	Bcbs Mt fee schedule · outpatient · +2 other terms	1	$170	$170	$107	63%	1–10	$24 – $293
21	Blue Cross Blue Shield facility · fee schedule · outpatient · +28 other terms	223	$109	$144	$135	94%	—	$6 – $1.2k
22	Tricare facility · fee schedule · outpatient · +15 other terms	101	$53	$63	$74	116%	—	$0 – $965
23	Oscar case rate · outpatient · +16 other terms	99	$173	$165	$51	31%	—	$36 – $222
24	MultiPlan fee schedule · outpatient · +17 other terms	88	$298	$307	$215	70%	—	$22 – $1.1k
25	Devoted facility · fee schedule · outpatient · +16 other terms	78	$55	$56	$39	71%	—	$0 – $194

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