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Alaska rates for HCPCS 76641

Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$108.94 / $149.96 / $434.27
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.70 / $175.00 / $385.38
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$32.67 / $39.07 / $149.96
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$178.89 / $402.00 / $415.77
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$66.03 / $88.67 / $240.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$113.09 / $169.07 / $328.14
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$40.71 / $66.20 / $127.82
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$72.37 / $102.87 / $200.32
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$247.45 / $296.94 / $597.11
Moda Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$84.10 / $100.92 / $231.44
Moda Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$163.35 / $196.02 / $365.62
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$377.50 / $440.80 / $612.00
Premera BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$130.00 / $150.80 / $208.00
Premera BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$247.50 / $290.00 / $404.00
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.53 / $328.14 / $604.00
Providence
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$74.55 / $154.50 / $233.81
Providence
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$170.35 / $298.50 / $461.57
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.24 / $328.15 / $557.86
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$55.71 / $103.99 / $217.31
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$114.11 / $162.16 / $320.52