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Idaho rates for HCPCS 77054

Mammary Ductogram Or Galactogram Multiple

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$173.60 / $173.60 / $173.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.20 / $100.47 / $138.76
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$314.62 / $776.70 / $1,344.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.97 / $111.71 / $143.61
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$260.62 / $260.62 / $289.32
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$68.20 / $147.09 / $261.08
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$111.01 / $127.83 / $162.13
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $38.11 / $120.90
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$468.21 / $586.01 / $887.19
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$121.11 / $142.47 / $162.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.66 / $95.48 / $160.66