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Utah rates for HCPCS 77048

Magnetic resonance imaging, breast, without and with contrast material(s), including computer-aided detection (CAD real-time lesion detection, characterization and pharmacokinetic analysis), when performed; unilateral

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$128.82 / $128.82 / $128.82
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$295.12 / $407.38 / $724.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$316.23 / $467.74 / $758.58
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $1,202.26
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.78 / $660.69 / $831.76
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$309.03 / $524.81 / $691.83
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $380.19 / $660.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.84 / $501.19 / $870.96