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
XR MAMMARY DCT/GL MUL
Plano, TX
See all hospitals reporting CPT 77054 →Price type
Medical City Plano’s median price of $309 is 16% above the median hospital's median price ($268), higher than 61% of the 1,715 hospitals reporting CPT 77054. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 11 payers, 51 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | UnitedHealthcare chip fee schedule · outpatient | $70 | $70 | — | — | — | $70 – $70 |
| 2 | UnitedHealthcare star fee schedule · outpatient | $70 | $70 | — | — | — | $70 – $70 |
| 3 | UnitedHealthcare starkids fee schedule · outpatient | $70 | $70 | — | — | — | $70 – $70 |
| 4 | UnitedHealthcare starperinate fee schedule · outpatient | $70 | $70 | — | — | — | $70 – $70 |
| 5 | UnitedHealthcare starplus fee schedule · outpatient | $70 | $70 | — | — | — | $70 – $70 |
| 6 | Cigna Healthspring mgmcd fee schedule · outpatient | $73 | $73 | — | — | — | $73 – $73 |
| 7 | Aetna Better Health chip fee schedule · outpatient | $75 | $75 | — | — | — | $75 – $75 |
| 8 | Aetna Better Health mcd fee schedule · outpatient | $75 | $75 | — | — | — | $75 – $75 |
| 9 | Molina chip fee schedule · outpatient | $77 | $77 | $1 | 1% | — | $76 – $78 |
| 10 | Molina mcdstar fee schedule · outpatient | $77 | $77 | $1 | 1% | — | $76 – $78 |
| 11 | Molina star+plus fee schedule · outpatient | $77 | $77 | $1 | 1% | — | $76 – $78 |
| 12 | Molina starkids fee schedule · outpatient | $77 | $77 | $1 | 1% | — | $76 – $78 |
| 13 | Aetna qhphix fee schedule · outpatient | $80 | $80 | — | — | — | $80 – $80 |
| 14 | Humana mgmcd fee schedule · outpatient | $87 | $87 | — | — | — | $87 – $87 |
| 15 | Aetna newbusiness fee schedule · outpatient | $109 | $109 | — | — | — | $109 – $109 |
| 16 | Aetna comm fee schedule · outpatient | $117 | $117 | — | — | — | $117 – $117 |
| 17 | Aetna meritain fee schedule · outpatient | $117 | $117 | — | — | — | $117 – $117 |
| 18 | Aetna oon fee schedule · outpatient | $137 | $137 | — | — | — | $137 – $137 |
| 19 | Superior Healthplan chip percent of total billed charges · outpatientfrom % of charges | $164 | $164 | — | — | — | $164 – $164 |
| 20 | Superior Healthplan mcdstar percent of total billed charges · outpatientfrom % of charges | $164 | $164 | — | — | — | $164 – $164 |
| 21 | Superior Healthplan starhealth percent of total billed charges · outpatientfrom % of charges | $164 | $164 | — | — | — | $164 – $164 |
| 22 | Superior Healthplan starkids percent of total billed charges · outpatientfrom % of charges | $164 | $164 | — | — | — | $164 – $164 |
| 23 | Superior Healthplan starplus percent of total billed charges · outpatientfrom % of charges | $164 | $164 | — | — | — | $164 – $164 |
| 24 | Cigna localplus fee schedule · outpatient | $193 | $193 | — | — | — | $193 – $193 |
| 25 | Cigna newbusiness fee schedule · outpatient | $193 | $193 | — | — | — | $193 – $193 |
Last updated: Mar 1, 2026
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