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West Virginia rates for HCPCS 77049

Mri Breast Without&With Contrast W/Cad Bilateral

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$106.33 / $116.96 / $116.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$328.00 / $367.56 / $522.50
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$97.17 / $140.00 / $236.54
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$221.67 / $255.48 / $368.50
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.71 / $345.40 / $702.42
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$124.62 / $124.62 / $124.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$298.57 / $596.30 / $1,623.04
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$94.73 / $156.50 / $508.27
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$203.84 / $439.60 / $1,114.77
Highmark BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$188.70 / $290.77 / $293.99
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$215.87 / $686.53 / $1,856.99
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$50.56 / $112.60 / $223.36
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$220.98 / $599.46 / $1,692.56