go back

South Carolina rates for HCPCS 76604

Ultrasound, chest (includes mediastinum), real time with image documentation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$22.91 / $30.20 / $35.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.86 / $85.11 / $323.59
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$22.91 / $40.74 / $117.49
Aetna
Facility/Professional
Professional
Modifier
52
Low / Median / High Price
$46.77 / $74.13 / $123.03
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$25.12 / $47.86 / $95.50
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.67 / $52.48 / $107.15
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$20.42 / $26.30 / $45.71
Ambetter
Facility/Professional
Professional
Modifier
52
Low / Median / High Price
$57.54 / $57.54 / $63.10
Ambetter
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$5.25 / $27.54 / $43.65
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $87.10 / $141.25
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$28.18 / $53.70 / $81.28
BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$30.90 / $36.31 / $56.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.61 / $93.33 / $154.88
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$25.12 / $35.48 / $53.70
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$34.67 / $60.26 / $97.72
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $33.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.07 / $83.18 / $138.04
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$23.44 / $29.51 / $51.29
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$40.74 / $53.70 / $91.20