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South Carolina 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
$56.23 / $269.15 / $269.15
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.23 / $69.18 / $123.03
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$309.03 / $575.44 / $1,122.02
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.61 / $141.25 / $251.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.77 / $302.00 / $1,202.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.10 / $102.33 / $186.21
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.54 / $144.54 / $144.54
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.26 / $102.33 / $194.98
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$229.09 / $1,000.00 / $1,513.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.18 / $97.72 / $204.17