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Indiana 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
$62.22 / $106.03 / $701.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.47 / $64.53 / $80.31
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$108.00 / $176.00 / $246.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.86 / $120.93 / $171.72
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.57 / $53.33 / $85.75
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.62 / $47.41 / $84.70
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.90 / $123.98 / $949.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.71 / $131.68 / $223.05
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$525.30 / $525.30 / $525.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.69 / $93.94 / $167.21