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Wisconsin 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
$151.36 / $151.36 / $208.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$288.40 / $398.11 / $794.33
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.84 / $562.34 / $1,905.46
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$263.03 / $302.00 / $489.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $758.58 / $1,412.54
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.96 / $758.58 / $1,023.29
Medica
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$933.25 / $933.25 / $933.25
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $933.25 / $2,290.87
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $70.79
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$436.52 / $776.25 / $1,148.15
Quartz
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$234.42 / $912.01 / $912.01
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.74 / $1,862.09 / $2,290.87
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,949.84 / $2,187.76 / $2,951.21
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$407.38 / $794.33 / $1,659.59