MRI Breast Without and With contrast bilateral
| DETAIL FOR SERVICES: | Study | Radiologist reading (interpretation) |
| 2020 CPT/HCPCS Primary Code | 77049 | Not provided by Hospital (may be billed separately) |
| Negotiated Private Fee | $830.00 | Not provided by Hospital (may be billed separately) |
| Prossam | $375.00 | Not provided by Hospital (may be billed separately) |
| Champva | $378.85 | Not provided by Hospital (may be billed separately) |
| First Medical | $312.50 | Not provided by Hospital (may be billed separately) |
| First Medical Vital | $206.53 | Not provided by Hospital (may be billed separately) |
| Plan de Salud Menonita | $276.25 | 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 | $412.50 | Not provided by Hospital (may be billed separately) |
| Mapfre | $325.00 | Not provided by Hospital (may be billed separately) |
| Mcsclassicare | $206.00 | Not provided by Hospital (may be billed separately) |
| MCS Life | $206.00 | Not provided by Hospital (may be billed separately) |
| Medicare | Ambulatory Payment classification (APC) | Not provided by Hospital (may be billed separately) |
| MMM | $378.85 | Not provided by Hospital (may be billed separately) |
| MMM Vital | $206.53 | Not provided by Hospital (may be billed separately) |
| Panamerican Life | $387.50 | Not provided by Hospital (may be billed separately) |
| PMC | $378.85 | Not provided by Hospital (may be billed separately) |
| Tricare | $377.40 | Not provided by Hospital (may be billed separately) |
| Triple S Salud | $342.00 | Not provided by Hospital (may be billed separately) |
| Triple S Vital | $191.00 | 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 | $191.00 | Not provided by Hospital (may be billed separately) |
| Negotiated Maximum Charge | $412.50 | Not provided by Hospital (may be billed separately) |
| Discounted Cash Price | $664.00 | Not provided by Hospital (may be billed separately) |
© 2024 Liga Puertorriqueña Contra el Cáncer. Diseñado por Wigo Technologies.
Política de Privacidad | Acreditaciones | Price Transparency
