Bilateral breast tomosynthesis imaging at Fairview Park Hospital

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

DUBLIN, GA

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How this price compares nationally

Fairview Park Hospital’s median price of $39 is 22% below the median hospital's median price ($50), higher than 35% of the 2,403 hospitals reporting CPT 77063. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 77063 at Fairview Park Hospital

Negotiated rates from the hospital’s own file: 9 payers, 26 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	Ambetter hix percent of total billed charges · outpatientfrom % of charges	$19.71	$19.71	$19.71 – $19.71
2	Humana tricare fee schedule · outpatient	$19.94	$19.94	$19.94 – $19.94
3	Devoted mcr fee schedule · outpatient	$20.86	$20.86	$20.86 – $20.86
4	Humana mgmcr fee schedule · outpatient	$20.86	$20.86	$20.86 – $20.86
5	UnitedHealthcare vaccn fee schedule · outpatient	$20.86	$20.86	$20.86 – $20.86
6	Aetna mcr fee schedule · outpatient	$21.07	$21.07	$21.07 – $21.07
7	UnitedHealthcare mcr fee schedule · outpatient	$21.28	$21.28	$21.28 – $21.28
8	WellCare mcr fee schedule · outpatient	$21.28	$21.28	$21.28 – $21.28
9	Blue Cross Blue Shield mcr fee schedule · outpatient	$21.49	$21.49	$21.49 – $21.49
10	Clover mcr fee schedule · outpatient	$21.90	$21.90	$21.90 – $21.90
11	WellCare mcd percent of total billed charges · outpatientfrom % of charges	$27.00	$27.00	$27.00 – $27.00
12	UnitedHealthcare optionsppo percent of total billed charges · outpatientfrom % of charges	$33.34	$33.34	$33.34 – $33.34
13	Aetna hmo fee schedule · outpatient	$46.96	$46.96	$46.96 – $46.96
14	Aetna openaccess fee schedule · outpatient	$46.96	$46.96	$46.96 – $46.96
15	Aetna pos fee schedule · outpatient	$46.96	$46.96	$46.96 – $46.96
16	Aetna ppo fee schedule · outpatient	$46.96	$46.96	$46.96 – $46.96
17	Aetna qualifiedhealthplan fee schedule · outpatient	$46.96	$46.96	$46.96 – $46.96
18	Blue Cross Blue Shield hix fee schedule · outpatient	$54.18	$53.07	$33.17 – $70.76
19	Blue Cross Blue Shield pathway fee schedule · outpatient	$54.18	$53.07	$33.17 – $70.76
20	UnitedHealthcare allpayerappendix fee schedule · outpatient	$57.31	$57.31	$57.31 – $57.31
21	Blue Cross Blue Shield hmo fee schedule · outpatient	$61.46	$60.20	$37.63 – $80.27
22	UnitedHealthcare globalbenefitplan percent of total billed charges · outpatientfrom % of charges	$60.75	$60.75	$60.75 – $60.75
23	Blue Cross Blue Shield ppo fee schedule · outpatient	$65.88	$64.54	$40.34 – $86.05
24	Aetna nap percent of total billed charges · outpatientfrom % of charges	$74.43	$74.43	$74.43 – $74.43
25	MultiPlan complementary percent of total billed charges · outpatientfrom % of charges	$121.50	$121.50	$121.50 – $121.50

Page 1 of 2 · 26 rates

Last updated: Mar 1, 2026

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