go back

South Carolina rates for HCPCS 77047

Mri Breast Without Contrast Material Bilateral

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$64.48 / $64.48 / $64.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$187.80 / $209.31 / $494.18
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$64.48 / $68.34 / $145.65
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$123.32 / $143.86 / $348.53
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$70.73 / $70.73 / $70.73
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$200.61 / $419.00 / $736.73
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$70.73 / $78.75 / $114.92
BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$129.88 / $344.00 / $654.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.19 / $307.94 / $531.46
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$81.56 / $101.27 / $177.43
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$168.62 / $202.79 / $354.03
Medcost
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$88.60 / $147.46 / $235.20
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$187.72 / $187.72 / $827.56
Medcost
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$279.45 / $279.45 / $279.45
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$96.53 / $150.80 / $279.41
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$242.73 / $404.44 / $1,391.70
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$70.91 / $98.30 / $163.59
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$163.69 / $270.23 / $1,153.89