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Texas rates for HCPCS 77053

Mammary Ductogram Or Galactogram Single

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$11.00 / $14.31 / $21.90
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$19.67 / $19.67 / $19.67
Lucent Health
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$48.89 / $80.00 / $83.60
Providence
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$19.67 / $19.67 / $19.67