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Wyoming rates for HCPCS 77047

Mri Breast Without Contrast Material Bilateral

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$72.43 / $72.43 / $73.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$175.21 / $294.08 / $475.00
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$60.68 / $85.30 / $140.00
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$114.53 / $208.78 / $335.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$587.00 / $964.00 / $1,781.00
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$193.00 / $317.00 / $586.00
BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$394.00 / $647.00 / $1,195.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$265.82 / $364.84 / $662.99
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$88.37 / $118.19 / $210.90
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$177.45 / $254.54 / $452.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$396.47 / $523.91 / $2,355.10
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$69.31 / $158.11 / $263.99
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$273.58 / $373.22 / $2,104.30