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Washington rates for HCPCS 77058

Mri Breast Unilateral

Insurance Carrier
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.33 / $1,000.00 / $1,659.59
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $70.79 / $75.86
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$741.31 / $1,023.29 / $1,412.54