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Iowa rates for HCPCS 77047

Mri Breast Without Contrast Material Bilateral

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$101.82 / $101.82 / $104.98
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$200.08 / $277.62 / $655.39
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$65.45 / $77.39 / $154.00
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$131.91 / $158.32 / $348.53
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$225.21 / $231.97 / $238.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$233.50 / $520.49 / $698.97
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$75.59 / $171.43 / $229.39
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$163.65 / $349.07 / $468.39
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$219.53 / $303.14 / $1,143.38
Hally Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$77.17 / $107.99 / $396.79
Hally Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$144.03 / $195.15 / $616.67
Medica
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$549.04 / $707.68 / $707.68
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$282.66 / $471.10 / $1,484.56
Medica
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$81.92 / $117.42 / $478.82
Medica
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$188.72 / $314.54 / $1,005.68
Midlands
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$231.97 / $238.72 / $420.00
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$427.43 / $473.22 / $752.85
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.30 / $204.31 / $364.55
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$255.51 / $408.82 / $912.19
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$81.92 / $117.42 / $237.33
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$173.59 / $275.22 / $743.48
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$391.05 / $495.00 / $582.40
Wellmark
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$132.33 / $167.50 / $197.10
Wellmark
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$258.73 / $327.50 / $385.40