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Diagnostic Mammogram, One Breast

South Dakota rates for HCPCS 77055

A mammogram, a low-dose X-ray of breast tissue, of one breast, done to look into a specific problem on that side such as a lump, pain, or an abnormal earlier result. Images are aimed at the area of concern.

Rates data updated October 2026.

How much rates vary

Facilitymedian $93 · 10th to 90th $93 to $138Professionalmedian $200 · 10th to 90th $129 to $251
$100$200facility $93professional $200

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Cigna
Setting
Professional
Modifier
None (both parts)
Typical Low
$128.82
Median
$199.53
Typical High
$251.19
Cigna
Setting
Professional
Modifier
26 · Professional part
Typical Low
$50.12
Median
$77.62
Typical High
$97.72
Cigna
Setting
Professional
Modifier
TC · Technical part
Typical Low
$79.43
Median
$123.03
Typical High
$154.88
Medica
Setting
Facility
Modifier
None
Typical Low
$93.33
Median
$93.33
Typical High
$138.04
Medica
Setting
Professional
Modifier
None (both parts)
Typical Low
$398.11
Median
$398.11
Typical High
$398.11