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Massachusetts rates for HCPCS 76642

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $257.04 / $549.54
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$25.12 / $31.62 / $128.82
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.95 / $112.20 / $407.38
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$30.20 / $69.18 / $173.78
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$69.18 / $190.55 / $630.96
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$43.65 / $64.57 / $257.04
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.07 / $194.98 / $549.54
AllWays Health Partners
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$35.48 / $79.43 / $204.17
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.44 / $114.82 / $549.54
AllWays Health Partners
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$27.54 / $42.66 / $204.17
AllWays Health Partners
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$44.67 / $74.13 / $338.84
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$70.79 / $109.65 / $177.83
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.15 / $165.96 / $245.47
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$37.15 / $63.10 / $85.11
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$74.13 / $204.17 / $295.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.13 / $125.89 / $245.47
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$28.18 / $46.77 / $91.20
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$44.67 / $81.28 / $151.36
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.23 / $97.72 / $7,079.46
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.69 / $83.18 / $165.96
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $144.54 / $223.87
Harvard Pilgrim
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$32.36 / $51.29 / $85.11
Harvard Pilgrim
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$54.95 / $89.13 / $141.25
Health New England
Facility/Professional
Facility
Modifier
Low / Median / High Price
$74.13 / $158.49 / $501.19
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.71 / $60.26 / $229.09
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.07 / $194.98 / $549.54
Mass General Brigham
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$35.48 / $79.43 / $204.17
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.44 / $114.82 / $549.54
Mass General Brigham
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$27.54 / $42.66 / $204.17
Mass General Brigham
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$44.67 / $74.13 / $338.84
Tufts
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.57 / $89.13 / $239.88
Tufts
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.81 / $75.86 / $158.49
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $123.03 / $251.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.18 / $120.23 / $234.42
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$30.90 / $44.67 / $87.10
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$51.29 / $75.86 / $147.91