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Missouri rates for HCPCS 76642

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

Facilitymedian $186 · 10th–90th $66$5620%5%10%10th90th$186Professionalmedian $78 · 10th–90th $34$3090%5%10th90th$78$10.0$20.0$50.0$100.0$200.0$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$81.28 / $218.78 / $588.84
Aetna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$31.62 / $38.90 / $75.86
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $95.50 / $407.38
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$28.84 / $63.10 / $151.36
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$48.98 / $147.91 / $676.08
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$41.69 / $57.54 / $154.88
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $66.07 / $141.25
Ambetter
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$23.99 / $31.62 / $53.70
Ambetter
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$81.28 / $91.20 / $97.72
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $97.72 / $158.49
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$33.88 / $38.90 / $63.10
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$120.23 / $144.54 / $239.88
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$46.77 / $56.23 / $95.50
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $87.10 / $204.17
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $91.20 / $128.82
BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$33.88 / $37.15 / $53.70
BCBS
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$51.29 / $56.23 / $81.28
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$104.71 / $177.83 / $245.47
Cigna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$7.94 / $37.15 / $52.48
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $104.71 / $199.53
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$28.18 / $41.69 / $85.11
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$43.65 / $64.57 / $128.82
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $120.23 / $338.84
Medica
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$75.86 / $147.91 / $147.91
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $102.33 / $549.54
Medica
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$30.90 / $41.69 / $204.17
Medica
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$46.77 / $61.66 / $338.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $85.11 / $177.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $95.50 / $162.18
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$30.90 / $38.90 / $87.10
United
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$123.03 / $123.03 / $125.89
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$46.77 / $58.88 / $109.65