RC 403

Screening mammogram at Northwest Hospital LLC

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

BR-TOMO MAMM SCR UNI

Tucson, AZ

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Pricing by billing methodology

Price type

How this price compares nationally

Northwest Hospital LLC’s median price of $74 is 45% below the median hospital's median price ($133), higher than 11% 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 Northwest Hospital LLC

Negotiated rates from the hospital’s own file: 15 payers, 33 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 node aetna mcr adv facility · fee schedule · outpatient	$23	$35	$28	81%	—	$11 – $87
2	Cigna Healthspring node cigna healthspring mcr adv facility · fee schedule · outpatient	$23	$35	$28	81%	—	$11 – $87
3	Humana node humana mcr adv facility · fee schedule · outpatient	$23	$35	$28	81%	—	$11 – $87
4	UnitedHealthcare node apipa uhc community plan mcr adv facility · per diem · outpatient	$23	$35	$28	81%	—	$11 – $87
5	UnitedHealthcare node uhc mcr adv facility · per diem · outpatient	$23	$36	$29	81%	—	$11 – $88
6	Clover node clover health mcr adv facility · fee schedule · outpatient	$23	$36	$29	81%	—	$12 – $89
7	Magellan node magellan mcr adv facility · fee schedule · outpatient	$24	$37	$30	81%	—	$12 – $91
8	WellCare node wellcare mcr adv facility · fee schedule · outpatient	$24	$37	$30	81%	—	$12 – $91
9	Devoted node devoted health mcr adv facility · other · outpatient	$23	$42	$32	76%	2–20	$12 – $89
10	Tricare node tricare facility · fee schedule · outpatient	$23	$49	$32	65%	—	$23 – $87
11	Ambetter node az complete health ambetter exchange facility · fee schedule · outpatient	$32	$50	$41	81%	—	$16 – $125
12	Aetna aetna qhp facility · fee schedule · outpatient	$30	$64	$42	66%	—	$30 – $116
13	Aetna aetna performance facility · fee schedule · outpatient	$33	$72	$47	66%	—	$33 – $130
14	Aetna aetna all facility · fee schedule · outpatient	$35	$76	$50	66%	—	$35 – $137
15	Medicaid az medicaid facility · other · outpatient	$60	$91	$54	60%	—	$30 – $182
16	UnitedHealthcare uhc hix facility · fee schedule · outpatient	$44	$94	$61	65%	—	$44 – $169
17	Magellan magellan medicaid az facility · other · outpatient	$63	$96	$57	60%	—	$32 – $191
18	UnitedHealthcare uhc navigate facility · fee schedule · outpatient	$46	$99	$65	65%	—	$46 – $178
19	Aetna aetna asbait facility · percent of total billed charges · inpatientfrom % of charges	$75	$114	$68	60%	—	$38 – $228
20	Aetna aetna asbait facility · percent of total billed charges · outpatientfrom % of charges	$75	$114	$68	60%	—	$38 – $228
21	UnitedHealthcare uhc apa facility · fee schedule · outpatient	$55	$117	$77	65%	—	$55 – $211
22	Cigna cigna hmo facility · fee schedule · outpatient	$74	$158	$103	65%	—	$74 – $285
23	Cigna cigna localflex facility · fee schedule · outpatient	$74	$158	$103	65%	—	$74 – $285
24	Cigna cigna localplus facility · fee schedule · outpatient	$74	$158	$103	65%	—	$74 – $285
25	Blue Cross Blue Shield bcbs pimaconnect facility · fee schedule · outpatient	$204	$204	$68	33%	—	$136 – $272

Page 1 of 2 · 33 rates

Last updated: Apr 1, 2026

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