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Arizona rates for HCPCS 77047

Magnetic resonance imaging, breast, without contrast material; bilateral

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$112.20 / $316.23 / $363.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.97 / $295.12 / $933.25
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$61.66 / $109.65 / $323.59
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$120.23 / $169.82 / $371.54
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.54 / $194.98 / $239.88
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$56.23 / $56.23 / $69.18
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.53 / $257.04 / $457.09
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$67.61 / $87.10 / $154.88
BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$134.90 / $169.82 / $302.00
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$18.62 / $85.11 / $123.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.97 / $302.00 / $549.54
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$57.54 / $91.20 / $162.18
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$120.23 / $194.98 / $380.19
Medica
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$549.54 / $707.95 / $707.95
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.78 / $602.56 / $1,479.11
Medica
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$66.07 / $74.13 / $478.63
Medica
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$147.91 / $478.63 / $1,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.78 / $489.78 / $977.24
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$66.07 / $70.79 / $125.89
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$147.91 / $389.05 / $870.96