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
Magnetic resonance imaging without contrast, breast; unilateral
Low
$250
Average
$308
Median
$305
High
$359
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
11 hospitals; the 90th percentile is 1.4× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
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11 hospital rates
iThe hospitals that file a Tricare 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 | Dallas Regional Medical Center Mesquite, TX fee schedule · outpatient | 1 | $280 | $280 | — | — | — | $280 – $280 |
| 2 | Garden Grove Hospital Medical Center Grove, CA fee schedule · outpatient | 1 | $359 | $359 | — | — | — | $359 – $359 |
| 3 | Huntington Beach Hospital Beach, CA fee schedule · outpatient | 2 | $359 | $359 | — | — | — | $359 – $359 |
| 4 | La Palma Intercommunity Hospital Palma, CA fee schedule · outpatient | 2 | $359 | $359 | — | — | — | $359 – $359 |
| 5 | Landmark Medical Center Woonsocket, RI fee schedule · outpatient | 1 | $314 | $314 | — | — | — | $314 – $314 |
| 6 | Lower Bucks Hospital Bristol, PA fee schedule · outpatient | 1 | $276 | $276 | — | — | — | $276 – $276 |
| 7 | North Vista Hospital Vegas, NV fee schedule · outpatient | 2 | $305 | $305 | — | — | — | $305 – $305 |
| 8 | Riverview Regional Medical Center Gadsden, AL fee schedule · outpatient | 1 | $250 | $250 | — | — | — | $250 – $250 |
| 9 | Saint John Hospital Leavenworth, KS fee schedule · outpatient | 2 | $264 | $264 | — | — | — | $264 – $264 |
| 10 | Saint Michaels Medical Center Newark, NJ fee schedule · outpatient | 1 | $260 | $260 | — | — | — | $260 – $260 |
| 11 | West Anaheim Medical Center Anaheim, CA fee schedule · outpatient | 1 | $359 | $359 | — | — | — | $359 – $359 |
← Payers reporting HCPCS C8904 · Snapshot 20261112T181611Z-3fa9fb76