MRI Breast Without contrast bilateral
| DETAIL FOR SERVICES: | Study | Radiologist reading (interpretation) |
| 2020 CPT/HCPCS Primary Code | 77047 | Not provided by Hospital (may be billed separately) |
| Negotiated Private Fee | $750.00 | Not provided by Hospital (may be billed separately) |
| Prossam | $250.00 | Not provided by Hospital (may be billed separately) |
| Champva | $239.78 | Not provided by Hospital (may be billed separately) |
| First Medical | $312.50 | Not provided by Hospital (may be billed separately) |
| First Medical Vital | $125.24 | Not provided by Hospital (may be billed separately) |
| Plan de Salud Menonita | $276.00 | Not provided by Hospital (may be billed separately) |
| Menonita Vital | $276.25 | Not provided by Hospital (may be billed separately) |
| Humana Gold Plus / Gold Choice | Ambulatory Payment classification (APC) | Not provided by Hospital (may be billed separately) |
| Humana | $375.00 | Not provided by Hospital (may be billed separately) |
| Mapfre | $325.00 | Not provided by Hospital (may be billed separately) |
| Mcsclassicare | $145.60 | Not provided by Hospital (may be billed separately) |
| MCS Life | $145.60 | Not provided by Hospital (may be billed separately) |
| Medicare | Ambulatory Payment classification (APC) | Not provided by Hospital (may be billed separately) |
| MMM | $239.78 | Not provided by Hospital (may be billed separately) |
| MMM Vital | $125.24 | Not provided by Hospital (may be billed separately) |
| Panamerican Life | $387.50 | Not provided by Hospital (may be billed separately) |
| PMC | $239.78 | Not provided by Hospital (may be billed separately) |
| Tricare | $239.83 | Not provided by Hospital (may be billed separately) |
| Triple S Salud | $325.00 | Not provided by Hospital (may be billed separately) |
| Triple S Vital | $332.71 | Not provided by Hospital (may be billed separately) |
| Triple S Advantage | Ambulatory Payment classification (APC) | Not provided by Hospital (may be billed separately) |
| Negotiated Minimum Charge | $125.24 | Not provided by Hospital (may be billed separately) |
| Negotiated Maximum Charge | $375.00 | Not provided by Hospital (may be billed separately) |
| Discounted Cash Price | $600.00 | Not provided by Hospital (may be billed separately) |
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Política de Privacidad | Acreditaciones | Price Transparency
