Health Plan - Highmark Delaware
Imaging/Radiology Services
Save time and money by having your outpatient imaging/radiology services completed at in-network non-hospital affiliated freestanding facilities. These facilities provide similar quality as hospital affiliated locations and are often more convenient.
Non-Hospital Facilities in Delaware
Highmark Delaware Comprehensive PPO Plan
Site of Care | Average Cost Per Visit | Your Cost Per Visit |
---|---|---|
Basic Imaging / Radiology (i.e., X-Ray, Ultrasound, Diagnostic 2D/3D Mammography) | ||
In-network non-hospital affiliated freestanding facility | $155 | $0 copay |
In-network hospital affiliated facility | $317 | $50 copay |
High-Tech Imaging / Radiology (i.e., MRI, CT Scan) Note: Requires a prior authorization |
||
In-network non-hospital affiliated freestanding facility | $377 | $0 copay |
In-network hospital affiliated facility | $1,089 | $100 copay |
Highmark Delaware First State Basic Plan
Site of Care | Average Cost Per Visit | Your Cost Per Visit |
---|---|---|
Basic Imaging / Radiology (i.e., X-Ray, Ultrasound, Diagnostic 2D/3D Mammography) |
||
In-network non-hospital affiliated freestanding facility | $155 | 10% coinsurance (after plan year deductible is met) |
In-network hospital affiliated facility | $317 | 10% coinsurance (after plan year deductible is met) |
High-Tech Imaging / Radiology (i.e., MRI, CT Scan) Note: Requires a prior authorization |
||
In-network non-hospital affiliated freestanding facility | $377 | 10% coinsurance (after plan year deductible is met) |
In-network hospital affiliated facility | $1,089 | 10% coinsurance (after plan year deductible is met) |
Frequently Asked Questions (FAQ)