Table 3:
Case mix and professional component fees by payer type
| CPT | Examination | Case Mix | Uninsured | Medicare5 | Medicaida | Private Insurance6 |
|---|---|---|---|---|---|---|
| 70551 | MR imaging brain WO contrast | 15% | $0 | $74.64 | $72.08 | $131.26 |
| 74178 | CT Abd/pelvis WO/W contrast | 15% | $0 | $102.53 | $88.15 | $173.22 |
| 76770 | US Abd complete | 10% | $0 | $37.14 | $32.59 | $63.33 |
| 77067 | Screening mammogram | 20% | $0 | $38.79 | $37.86 | $63.67 |
| 71046 | XR chest single | 40% | $0 | $10.25 | $8.52 | $18.70 |
| Total | 100% |
Note:—W indicates with; WO, without; Abd, abdomen; US, ultrasound; XR, x-ray.
a
Medicaid fees represent hospital-based Medicaid PC fee averages in Louisiana for the respective examinations and were provided by the Radiology Finance Department of our lead study site.