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Michigan rates for HCPCS 77053

Mammary Ductogram Or Galactogram Single

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$20.32 / $20.32 / $21.34
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$19.67 / $19.67 / $19.67
Health Alliance Plan
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$13.43 / $13.43 / $20.32