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
$219
Average
$824
Median
$515
High
$2.3k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
10 payers; the 90th percentile is 7.4× 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 | Aetna case rate · outpatient · +1 other terms | 20 | $1.6k | $2.0k | $866 | 43% | — | $1.4k – $4.6k |
| 2 | Molina facility · case rate · outpatient | 4 | $397 | $418 | $97 | 23% | — | $306 – $574 |
| 3 | Humana facility · case rate · outpatient | 3 | $255 | $263 | $12 | 5% | — | $255 – $280 |
| 4 | UnitedHealthcare facility · case rate · outpatient · +1 other terms | 3 | $280 | $686 | $908 | 132% | — | $146 – $2.5k |
| 5 | Wellmark facility · case rate · outpatient | 3 | $973 | $854 | $269 | 32% | — | $397 – $1.1k |
| 6 | Cigna case rate · both · +1 other terms | 2 | $2.5k | $2.5k | — | — | — | $2.5k – $2.5k |
| 7 | Aetna Better Health facility · case rate · outpatient | 1 | $295 | $295 | $2 | 1% | — | $293 – $298 |
| 8 | Amerihealth Caritas facility · case rate · outpatient | 1 | $306 | $306 | — | — | — | $306 – $306 |
| 9 | Excellus facility · case rate · outpatient | 1 | $612 | $612 | $393 | 64% | — | $219 – $1.0k |
| 10 | WellCare facility · case rate · outpatient | 1 | $219 | $219 | — | — | — | $219 – $219 |
← Hospitals reporting CPT 77058 · Snapshot 20261113T090226Z-3ce6c0b8