RC 403

Screening mammogram at Mercy Hospital Fort Smith

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

Mamm Scrn Right W Cad

Smith, AR

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Pricing by billing methodology

Price type

How this price compares nationally

Mercy Hospital Fort Smith’s median price of $77 is 42% below the median hospital's median price ($133), higher than 13% of the 1,823 hospitals reporting RC 403. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting RC 403 at Mercy Hospital Fort Smith

Negotiated rates from the hospital’s own file: 17 payers, 29 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	Medicaid hb ftsm ok medicaid facility · fee schedule · outpatient	$77	$53	$28	54%	—	$20 – $77
2	Aetna hb ftsm managed medicare facility · fee schedule · outpatient	$77	$53	$28	54%	—	$20 – $77
3	Blue Cross Blue Shield hb ftsm managed medicare facility · fee schedule · outpatient	$77	$53	$28	54%	—	$20 – $77
4	First Health hb ftsm managed medicare facility · fee schedule · outpatient	$77	$53	$28	54%	—	$20 – $77
5	Humana hb ftsm humana mcr facility · fee schedule · outpatient	$77	$53	$28	54%	—	$20 – $77
6	Medica hb ftsm managed medicare facility · fee schedule · outpatient	$77	$53	$28	54%	—	$20 – $77
7	Medicare hb ftsm medicare facility · fee schedule · outpatient	$77	$53	$28	54%	—	$20 – $77
8	Tricare hb ftsm tricare facility · fee schedule · outpatient	$77	$53	$28	54%	—	$20 – $77
9	UnitedHealthcare hb ftsm managed medicare facility · fee schedule · outpatient	$77	$53	$28	54%	—	$20 – $77
10	UnitedHealthcare hb ftsm uhc mcr 100% facility · fee schedule · outpatient	$77	$53	$28	54%	—	$20 – $77
11	WellCare hb ftsm novasys mcr 103% facility · fee schedule · outpatient	$79	$54	$29	54%	—	$20 – $79
12	Devoted hb ftsm devoted health mcr facility · fee schedule · outpatient	$80	$55	$30	54%	—	$21 – $80
13	Cigna hb ftsm healthspring cigna mcr 105% facility · fee schedule · outpatient	$81	$55	$30	54%	—	$21 – $81
14	Medicaid hb ftsm ark medicaid facility · fee schedule · outpatient	$99	$66	$38	57%	—	$23 – $99
15	Caresource hb ftsm caresource medicaid facility · fee schedule · outpatient	$101	$68	$38	57%	—	$23 – $101
16	Blue Cross Blue Shield hb ftsm bcbs exchange facility · fee schedule · outpatient	$93	$71	$25	35%	—	$43 – $93
17	Ambetter hb ftsm novasys ambetter exchange facility · fee schedule · outpatient	$110	$75	$40	54%	—	$28 – $110
18	Anthem hb ftsm blue cross facility · fee schedule · outpatient	$104	$80	$28	35%	—	$48 – $104
19	Blue Cross Blue Shield hb ftsm blue cross facility · fee schedule · outpatient	$104	$80	$28	35%	—	$48 – $104
20	Medicaid hb ftsm mo medicaid facility · fee schedule · outpatient	$108	$81	$31	39%	—	$44 – $108
21	Aetna hb ftsm ok managed medicaid facility · fee schedule · outpatient	$109	$82	$32	39%	—	$45 – $109
22	Humana hb ftsm ok managed medicaid facility · fee schedule · outpatient	$109	$82	$32	39%	—	$45 – $109
23	First Health hb ftsm first health_ccn facility · percent of total billed charges · outpatientfrom % of charges	$125	$126	$41	32%	55	$87 – $186
24	Cigna hb ftsm cigna facility · fee schedule · outpatient	$188	$128	$69	54%	—	$48 – $188
25	Aetna hb ftsm coventry/aetna facility · percent of total billed charges · outpatientfrom % of charges	$130	$131	$42	32%	265	$90 – $193

Page 1 of 2 · 29 rates

Last updated: Jun 8, 2026

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