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Wyoming rates for HCPCS 77049

Mri Breast Without&With Contrast W/Cad Bilateral

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$104.79 / $104.79 / $106.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.01 / $467.03 / $475.00
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$87.13 / $123.12 / $140.00
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$187.88 / $335.00 / $343.92
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$919.00 / $1,510.00 / $2,789.00
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$278.00 / $456.00 / $842.00
BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$641.00 / $1,054.00 / $1,947.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$419.05 / $610.73 / $1,143.58
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$126.41 / $170.36 / $301.58
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$292.64 / $419.77 / $745.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$626.63 / $779.41 / $2,416.14
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$72.18 / $205.38 / $308.52
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$444.07 / $572.38 / $2,155.08