CPT 77054
Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
HC GALACTOGRAM, MULTIPLE DUCTS
Low
$32
Average
$158
Median
$99
High
$670
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59 hospital rates
iThe hospitals that file a Medicaid rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | ADVENTIST HEALTH DELANO Delano, CA fee schedule · outpatient | 1 | $99 | $99 | — | — | — | $99 – $99 |
| 2 | ADVENTIST HEALTH MEDICAL CENTER TEHACHAPI Tehachapi, CA fee schedule · outpatient | 1 | $99 | $87 | $17 | 19% | — | $64 – $99 |
| 3 | ADVENTIST HEALTH MENDOCINO COAST Bragg, CA fee schedule · outpatient | 1 | $64 | $64 | — | — | — | $64 – $64 |
| 4 | ADVENTIST HEALTH TULARE Tulare, CA fee schedule · outpatient | 1 | $81 | $81 | $18 | 22% | — | $64 – $99 |
| 5 | BAPTIST HOSPITAL OF MIAMI PLANTATION, FL fee schedule · both | 2 | $77 | $77 | $4 | 5% | — | $74 – $81 |
| 6 | BYRD REGIONAL HOSPITAL LEESVILLE, LA fee schedule · both | 5 | $163 | $163 | — | — | — | $163 – $163 |
| 7 | BYRD REGIONAL HOSPITAL LEESVILLE, LA percent of total billed charges · bothfrom % of charges | 5 | $170 | $170 | $7 | 4% | — | $163 – $177 |
| 8 | Butler Healthcare Providers_ DBA Butler Memorial Hospital Butler, PA facility · fee schedule · outpatient | 1 | $76 | $76 | — | — | — | $76 – $76 |
| 9 | CATHOLIC HEALTH INITIATIVES COLORADO Salt Lake City, UT fee schedule · outpatient | 1 | $37 | $37 | — | — | — | $37 – $37 |
| 10 | Chapman Global Medical Center Orange, CA facility · fee schedule · outpatient | 1 | $64 | $64 | — | — | — | $64 – $64 |
| 11 | Chilton Medical Center Pompton Plains, NJ percent of total billed charges · bothfrom % of charges | 1 | $153 | $153 | — | — | — | $153 – $153 |
| 12 | Clarion Hospital Clarion, PA facility · fee schedule · outpatient | 1 | $76 | $76 | — | — | — | $76 – $76 |
| 13 | Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL facility · case rate · outpatient | 1 | $75 | $75 | — | — | — | $75 – $75 |
| 14 | Dupont Hospital LLC Wayne, IN facility · other · outpatient | 1 | $156 | $156 | — | — | — | $156 – $156 |
| 15 | Eisenhower Medical Center Rancho Mirage, CA fee schedule · both | 3 | $64 | $64 | — | — | — | $64 – $64 |
| 16 | Emerson Hospital Concord, MA facility · fee schedule · outpatient | 1 | $237 | $237 | — | — | — | $237 – $237 |
| 17 | FISHERMENS HEALTH, INC MARATHON, FL fee schedule · both | 2 | $75 | $75 | $4 | 5% | — | $71 – $79 |
| 18 | Fairview Maple Grove Surgery Center Maple Grove, MN fee schedule · both | 1 | $32 | $32 | $17 | 55% | — | $14 – $49 |
| 19 | GLENDALE ADVENTIST MEDICAL CENTER Glendale, CA fee schedule · outpatient | 1 | $99 | $99 | — | — | — | $99 – $99 |
| 20 | HANFORD COMMUNITY HOSPITAL Selma, CA fee schedule · outpatient | 1 | $81 | $81 | $18 | 22% | — | $64 – $99 |
| 21 | HOMESTEAD HOSPITAL Homestead, FL fee schedule · both | 2 | $75 | $75 | $4 | 5% | — | $71 – $79 |
| 22 | Henry Ford Health Novi, MI other · outpatient | 1 | $137 | $137 | — | — | — | $137 – $137 |
| 23 | Henry Ford Health Twp, MI other · outpatient | 1 | $141 | $141 | — | — | — | $141 – $141 |
| 24 | Henry Ford Health Southfield, MI other · outpatient | 1 | $137 | $137 | — | — | — | $137 – $137 |
| 25 | Henry Ford Health Rochester, MI other · outpatient | 1 | $128 | $128 | — | — | — | $128 – $128 |
← Payers reporting CPT 77054 · Snapshot 20261113T090226Z-3ce6c0b8