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.
Original text from hospital filings
Breast tomosynthesis bi
Portage, WI
See all hospitals reporting CPT 77063 →Price type
Aspirus Divine Savior Hospital’s median price of $50 is about the same as the median hospital's median price ($50), higher than 51% of the 2,403 hospitals reporting CPT 77063. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 9 payers, 23 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | ||||
|---|---|---|---|---|
| 1 | Aetna medicare advantage esa fee schedule · outpatient | $22.40 | $22.40 | $22.40 – $22.40 |
| 2 | Anthem anthem mediblue access ppo fee schedule · outpatient | $22.85 | $22.85 | $22.85 – $22.85 |
| 3 | UnitedHealthcare united healthcare wisconsin medicaid plans fee schedule · both | $22.86 | $22.86 | $22.86 – $22.86 |
| 4 | Anthem anthem wisconsin medicaid plans fee schedule · both | $23.32 | $23.32 | $23.32 – $23.32 |
| 5 | Humana humana medicare ppo/pos/hmo network plans fee schedule · both | $26.01 | $26.01 | $26.01 – $26.01 |
| 6 | Anthem anthem mediblue access ppo fee schedule · both | $26.53 | $26.53 | $26.53 – $26.53 |
| 7 | Anthem anthem mediblue dual hmo snp fee schedule · both | $26.53 | $26.53 | $26.53 – $26.53 |
| 8 | Anthem anthem medicare advantage plans fee schedule · both | $26.53 | $26.53 | $26.53 – $26.53 |
| 9 | Tricare tricare plans fee schedule · both | $26.53 | $26.53 | $26.53 – $26.53 |
| 10 | UnitedHealthcare united healthcare medicare advantage plans fee schedule · both | $26.53 | $26.53 | $26.53 – $26.53 |
| 11 | UnitedHealthcare va community care network fee schedule · both | $26.54 | $26.54 | $26.54 – $26.54 |
| 12 | First Health first health national rental ppo network fee schedule · both | $50.41 | $50.41 | $50.41 – $50.41 |
| 13 | MultiPlan aetna health plan ppo networks fee schedule · both | $63.08 | $63.08 | $63.08 – $63.08 |
| 14 | Anthem anthem blue preferred pos fee schedule · both | $132.81 | $132.81 | $132.81 – $132.81 |
| 15 | Aetna medicare advantage esa fee schedule · both | $138.00 | $138.00 | $138.00 – $138.00 |
| 16 | Anthem anthem blue access ppo fee schedule · both | $139.45 | $139.45 | $139.45 – $139.45 |
| 17 | Anthem anthem federal employee program fee schedule · both | $139.45 | $139.45 | $139.45 – $139.45 |
| 18 | MultiPlan health eos ppos network plans fee schedule · both | $160.00 | $160.00 | $160.00 – $160.00 |
| 19 | Anthem anthem blue access ppo fee schedule · outpatient | $168.00 | $168.00 | $168.00 – $168.00 |
| 20 | UnitedHealthcare united healthcare hmo/ppo/pos/epo networks fee schedule · both | $171.99 | $171.99 | $171.99 – $171.99 |
| 21 | Cigna cigna ppo and open access plus benefit plans fee schedule · both | $176.00 | $176.00 | $176.00 – $176.00 |
| 22 | Healthpartners health partners commercial ppo fee schedule · both | $182.40 | $182.40 | $182.40 – $182.40 |
| 23 | MultiPlan multiplan ppo network plans fee schedule · both | $200.00 | $200.00 | $200.00 – $200.00 |
Last updated: Apr 1, 2026
See Bilateral breast tomosynthesis imaging pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.