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Diagnostic Mammogram, One Breast

Wisconsin 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 does Diagnostic Mammogram, One Breast cost?

$398

Typical facility fee. In Wisconsin, October 2026.

Insurers have agreed to pay about $398 for this service. Most negotiated rates run $162 to $398.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 4 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $257 · 10th to 90th $166 to $389Professionalmedian $398 · 10th to 90th $145 to $398
$200$500facility $257professional $398

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
Facility
Modifier
None
Typical Low
$229.09
Median
$257.04
Typical High
$389.05
Cigna
Setting
Professional
Modifier
None (both parts)
Typical Low
$128.82
Median
$162.18
Typical High
$199.53
Cigna
Setting
Professional
Modifier
26 · Professional part
Typical Low
$50.12
Median
$61.66
Typical High
$75.86
Cigna
Setting
Professional
Modifier
TC · Technical part
Typical Low
$79.43
Median
$97.72
Typical High
$120.23
DeanCare
Setting
Facility
Modifier
None
Typical Low
$165.96
Median
$165.96
Typical High
$165.96
Medica
Setting
Facility
Modifier
None
Typical Low
$165.96
Median
$165.96
Typical High
$165.96
Medica
Setting
Professional
Modifier
None (both parts)
Typical Low
$398.11
Median
$398.11
Typical High
$398.11
Medica
Setting
Professional
Modifier
26 · Professional part
Typical Low
$169.82
Median
$169.82
Typical High
$169.82
Medica
Setting
Professional
Modifier
TC · Technical part
Typical Low
$208.93
Median
$208.93
Typical High
$208.93
Prevea360
Setting
Facility
Modifier
None
Typical Low
$165.96
Median
$165.96
Typical High
$165.96

Where Wisconsin sits

The same service costs 13.2 times more in Arizona than in South Carolina. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Wisconsin· 3rd of 32

$398

AZ $398SC $30.20

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.