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Arizona rates for HCPCS 77054

Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$256.42 / $256.42 / $256.42
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.25 / $69.23 / $99.24
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.65 / $153.54 / $252.96
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.06 / $72.06 / $90.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$210.12 / $509.25 / $717.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.80 / $106.48 / $185.88
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$65.84 / $92.19 / $214.97
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.17 / $113.86 / $678.50
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$230.13 / $230.13 / $525.41
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.70 / $95.48 / $159.93