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Michigan rates for HCPCS 77047

Magnetic resonance imaging, breast, without contrast material; bilateral

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$89.13 / $93.33 / $112.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.97 / $338.84 / $758.58
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$64.57 / $109.65 / $302.00
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$123.03 / $190.55 / $371.54
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.88 / $239.88 / $239.88
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$67.61 / $67.61 / $85.11
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$316.23 / $331.13 / $354.81
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$120.23 / $120.23 / $120.23
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
$204.17 / $338.84 / $707.95
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$63.10 / $100.00 / $218.78
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$141.25 / $223.87 / $446.68
Health Alliance Plan
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$89.13 / $112.20 / $186.21
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.53 / $263.03 / $645.65
Health Alliance Plan
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$64.57 / $89.13 / $245.47
Health Alliance Plan
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$134.90 / $173.78 / $389.05
Priority Health
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$18.62 / $85.11 / $123.03
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.21 / $269.15 / $602.56
Priority Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$57.54 / $83.18 / $199.53
Priority Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$123.03 / $177.83 / $407.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.42 / $512.86 / $1,023.29
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$72.44 / $85.11 / $134.90
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$158.49 / $380.19 / $912.01