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California 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
$92.56 / $481.47 / $1,827.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.47 / $79.05 / $425.63
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.75 / $348.45 / $876.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.61 / $117.37 / $253.20
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$59.40 / $134.08 / $614.07
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.26 / $97.59 / $229.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$99.64 / $620.40 / $1,461.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.68 / $119.00 / $220.42
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.76 / $89.71 / $121.11
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.88 / $89.27 / $157.26
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$224.86 / $368.74 / $368.74
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$678.50 / $698.85 / $698.85
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $46.81
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$65.62 / $98.67 / $282.93
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.22 / $131.76 / $211.30
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$244.92 / $244.92 / $244.92
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.55 / $89.26 / $108.38
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79.63 / $79.63 / $79.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.97 / $95.21 / $213.85