CPT 77058
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 MRI Breast Unilat W&W/O Con
Low
$1
Average
$2.4k
Median
$1.3k
High
$33.5k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
34 payers; the 90th percentile is 5.3× the 10th. Each bar is a price range and its height is how many payers fall in it. Hover a bar, or a row in the ladder, for details.
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| # | ||||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Blue Cross Blue Shield fee schedule · outpatient · +15 other terms | 46 | $1.7k | $1.9k | $873 | 46% | — | $569 – $4.3k |
| 2 | Aetna fee schedule · outpatient · +19 other terms | 44 | $1.7k | $2.8k | $1.6k | 56% | — | $267 – $5.1k |
| 3 | Cigna fee schedule · outpatient · +16 other terms | 21 | $1.2k | $1.9k | $2.1k | 107% | — | $563 – $7.2k |
| 4 | Anthem fee schedule · both · +5 other terms | 17 | $249 | $249 | $137 | 55% | — | $58 – $374 |
| 5 | Humana fee schedule · outpatient · +10 other terms | 14 | $8.1k | $7.6k | $1.9k | 25% | — | $820 – $8.1k |
| 6 | Wellmark fee schedule · both · +2 other terms | 13 | $844 | $842 | $498 | 59% | — | $147 – $1.4k |
| 7 | Highmark fee schedule · outpatient · +5 other terms | 10 | $452 | $452 | $250 | 55% | — | $98 – $680 |
| 8 | Tricare fee schedule · outpatient · +1 other terms | 10 | $470 | $470 | — | — | — | $470 – $470 |
| 9 | MultiPlan fee schedule · outpatient · +6 other terms | 8 | $728 | $734 | $93 | 13% | — | $602 – $865 |
| 10 | First Health fee schedule · both · +4 other terms | 5 | $620 | $620 | $368 | 59% | — | $102 – $929 |
← Hospitals reporting CPT 77058 · Snapshot 20261113T090226Z-3ce6c0b8