RC 403
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
Olivia, MN
See all hospitals reporting RC 403 →Price type
Olivia Hospital’s median price of $165 is 23% above the median hospital's median price ($133), higher than 62% of the 1,823 hospitals reporting RC 403. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 6 payers, 12 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 | UnitedHealthcare uhc wi community plan [50274] facility · fee schedule · both | $64 | $64 | $27 | 42% | — | $37 – $91 |
| 2 | Blue Cross Blue Shield bcbs medicare advantage [50299] facility · percent of total billed charges · bothfrom % of charges | $114 | $114 | $50 | 44% | 245 | $63 – $164 |
| 3 | UnitedHealthcare uhc medicare advantage ppo [50275] facility · percent of total billed charges · bothfrom % of charges | $116 | $116 | $51 | 44% | 2–20 | $65 – $167 |
| 4 | Medica medica government advantage [50316] facility · percent of total billed charges · bothfrom % of charges | $117 | $117 | $52 | 44% | 13 | $65 – $169 |
| 5 | Ucare ucare pmap [50283] facility · percent of total billed charges · bothfrom % of charges | $117 | $117 | $52 | 44% | — | $65 – $169 |
| 6 | Blue Cross Blue Shield bcbs pmap [95296] facility · fee schedule · both | $124 | $124 | $41 | 33% | — | $83 – $165 |
| 7 | Medica medica choice care pmap [50314] facility · percent of total billed charges · bothfrom % of charges | $134 | $134 | $59 | 44% | — | $75 – $194 |
| 8 | Healthpartners hp self insured [91021] facility · percent of total billed charges · bothfrom % of charges | $289 | $289 | $128 | 44% | 70 | $161 – $417 |
| 9 | Medica medica choice [90156] facility · percent of total billed charges · bothfrom % of charges | $317 | $317 | $140 | 44% | 48 | $177 – $457 |
| 10 | First Health first health network [95334] facility · percent of total billed charges · bothfrom % of charges | $322 | $322 | $142 | 44% | — | $179 – $464 |
| 11 | UnitedHealthcare uhc [50131] facility · percent of total billed charges · bothfrom % of charges | $328 | $328 | $145 | 44% | 13 | $183 – $474 |
| 12 | Blue Cross Blue Shield bcbs mn [90043] facility · fee schedule · both | $371 | $371 | $124 | 33% | — | $248 – $495 |
Last updated: Mar 31, 2026
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