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Michigan rates for HCPCS 77047

Mri Breast Without Contrast Material Bilateral

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$90.04 / $90.04 / $94.55
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$202.11 / $342.97 / $522.50
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$67.95 / $116.83 / $265.19
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$134.16 / $215.34 / $368.50
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.26 / $144.26 / $144.26
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$58.17 / $100.31 / $100.31
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.05 / $347.72 / $447.07
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$119.84 / $119.84 / $119.84
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$86.45 / $86.45 / $86.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$220.43 / $336.15 / $604.22
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$59.51 / $94.66 / $187.24
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$144.41 / $221.48 / $421.72
Health Alliance Plan
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$63.98 / $90.04 / $94.55
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$197.71 / $260.95 / $475.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$63.98 / $90.05 / $262.89
Health Alliance Plan
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$133.74 / $170.91 / $335.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.67 / $137.19 / $260.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$240.42 / $607.79 / $1,061.75
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$72.48 / $85.26 / $125.51
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$164.91 / $509.62 / $892.33