MRI Breast Without and With contrast unilateral
| DETAIL FOR SERVICES: | Study | Radiologist reading (interpretation) |
| 2020 CPT/HCPCS Primary Code | 77048 | Not provided by Hospital (may be billed separately) |
| Negotiated Private Fee | $730.00 | Not provided by Hospital (may be billed separately) |
| Prossam | $225.00 | Not provided by Hospital (may be billed separately) |
| Champva | $370.90 | Not provided by Hospital (may be billed separately) |
| First Medical | $312.50 | Not provided by Hospital (may be billed separately) |
| First Medical Vital | $207.54 | 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 | $362.50 | Not provided by Hospital (may be billed separately) |
| Mapfre | $325.00 | Not provided by Hospital (may be billed separately) |
| Mcsclassicare | $202.00 | Not provided by Hospital (may be billed separately) |
| MCS Life | $202.00 | Not provided by Hospital (may be billed separately) |
| Medicare | Ambulatory Payment classification (APC) | Not provided by Hospital (may be billed separately) |
| MMM | $370.90 | Not provided by Hospital (may be billed separately) |
| MMM Vital | $207.54 | Not provided by Hospital (may be billed separately) |
| Panamerican Life | $387.50 | Not provided by Hospital (may be billed separately) |
| PMC | $387.50 | Not provided by Hospital (may be billed separately) |
| Tricare | $369.79 | Not provided by Hospital (may be billed separately) |
| Triple S Salud | $342.00 | Not provided by Hospital (may be billed separately) |
| Triple S Vital | $191.10 | 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 | $191.10 | Not provided by Hospital (may be billed separately) |
| Negotiated Maximum Charge | $387.50 | Not provided by Hospital (may be billed separately) |
| Discounted Cash Price | $584.00 | Not provided by Hospital (may be billed separately) |
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Política de Privacidad | Acreditaciones | Price Transparency
