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Pennsylvania rates for HCPCS 76641

Us Breast Uni Real Time With Image Complete

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$31.10 / $36.20 / $70.34
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.79 / $104.51 / $441.00
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$29.35 / $35.59 / $110.00
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$59.42 / $247.50 / $749.61
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$55.93 / $69.40 / $126.90
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.00 / $75.84 / $81.79
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$27.97 / $40.53 / $78.98
Ambetter
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$92.28 / $114.37 / $154.88
Ambetter
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$74.09 / $74.09 / $74.09
AmeriHealth
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.74 / $128.00 / $223.59
AmeriHealth
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$36.03 / $41.22 / $74.91
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.70 / $163.71 / $192.95
Capital Blue Cross
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$36.86 / $56.51 / $68.58
Capital Blue Cross
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$157.05 / $245.55 / $289.41
Capital Blue Cross
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$67.84 / $106.92 / $124.37
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$39.72 / $39.72 / $39.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.29 / $133.91 / $203.37
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$27.97 / $45.86 / $70.19
Cigna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$138.68 / $138.68 / $157.99
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$53.77 / $87.51 / $135.74
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119.08 / $141.54 / $242.82
Emblem Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$39.60 / $50.58 / $79.25
Emblem Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$80.16 / $103.06 / $163.57
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.21 / $115.88 / $130.01
Highmark BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$38.64 / $52.26 / $81.15
Highmark BCBS
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$63.38 / $169.72 / $204.76
Highmark BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$119.97 / $119.97 / $145.71
Independence Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.74 / $121.12 / $196.17
Independence Blue Cross
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$34.90 / $41.22 / $74.91
Martin's Point
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$31.10 / $40.43 / $107.03
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.91 / $111.59 / $275.69
Martin's Point
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$31.10 / $46.07 / $110.00
Martin's Point
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$50.33 / $199.80 / $749.61
Martin's Point
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$59.85 / $76.75 / $156.79
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.36 / $120.40 / $171.20
Priority Health
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$39.72 / $39.72 / $39.72
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.81 / $132.01 / $203.37
Priority Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$28.52 / $45.86 / $70.19
Priority Health
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$138.68 / $157.99 / $157.99
Priority Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$55.77 / $86.71 / $130.74
UPMC Health Plan
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$34.50 / $34.50 / $40.51
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.55 / $99.94 / $113.98
UPMC Health Plan
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$33.61 / $34.52 / $40.51
UPMC Health Plan
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$64.02 / $65.44 / $73.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.13 / $116.40 / $197.73
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$29.83 / $39.61 / $67.18
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$53.84 / $77.75 / $133.47