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Nebraska rates for HCPCS 77047

Magnetic resonance imaging, breast, without contrast material; bilateral

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$72.43 / $72.89 / $72.89
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$215.09 / $475.00 / $1,456.51
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$72.89 / $140.00 / $154.79
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$136.24 / $142.19 / $1,003.92
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$169.71 / $169.71 / $169.71
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.97 / $416.83 / $427.25
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$133.15 / $142.31 / $145.88
BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$256.82 / $274.51 / $281.38
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$420.00 / $420.00 / $420.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$288.06 / $494.32 / $650.62
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$96.31 / $166.69 / $214.29
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$191.75 / $325.30 / $436.33
Medica
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$707.68 / $707.68 / $707.68
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$353.19 / $588.65 / $1,484.56
Medica
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$93.48 / $154.53 / $478.82
Medica
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$236.34 / $393.90 / $1,057.35
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 / $524.85 / $698.97
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.30 / $204.23 / $364.55
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$353.19 / $543.79 / $1,005.98
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$93.48 / $151.91 / $194.75
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$236.34 / $363.88 / $917.63