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Wisconsin rates for HCPCS 77053

Mammary ductogram or galactogram, single duct, radiological supervision and interpretation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$25.12 / $25.12 / $35.48
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$47.86 / $54.95 / $83.18
Medica
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$79.43 / $79.43 / $79.43
Quartz
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$39.81 / $109.65 / $109.65