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Wisconsin rates for HCPCS 77048

Mri Breast W/Out&With Contrast W/Cad Unilateral

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$150.04 / $208.67 / $208.67
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$310.89 / $494.18 / $1,127.16
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$339.64 / $824.39 / $2,223.59
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$260.42 / $304.33 / $404.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$461.60 / $1,214.90 / $1,380.56
Medica
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$931.68 / $931.68 / $931.68
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$473.41 / $1,089.58 / $2,291.23
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$80.06 / $206.16 / $601.90
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$613.20 / $806.15 / $1,160.58
Quartz
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$236.73 / $931.68 / $931.68
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$511.68 / $1,878.60 / $2,291.23
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,986.98 / $2,164.78 / $2,632.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$450.86 / $1,014.44 / $2,108.94