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Wisconsin rates for HCPCS 70554

Magnetic resonance imaging, brain, functional MRI; including test selection and administration of repetitive body part movement and/or visual stimulation, not requiring physician or psychologist administration

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$208.93 / $208.93 / $234.42
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$263.03 / $309.03 / $489.78
Medica
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$457.09 / $457.09 / $457.09
Quartz
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$234.42 / $630.96 / $630.96