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Montana rates for HCPCS 76642

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

Facilitymedian $269 · 10th–90th $110$7240%10%10th90th$269Professionalmedian $83 · 10th–90th $33$2750%10%10th90th$83$10.0$50.0$200.0$1.0K$5.0K$20.0K$100.0K

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
$141.25 / $331.13 / $724.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $95.50 / $309.03
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$30.90 / $63.10 / $144.54
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$56.23 / $141.25 / $616.60
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$47.86 / $67.61 / $162.18
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $66,069.34 / $95,499.26
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $134.90
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$81.28 / $112.20 / $309.03
Cigna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$50.12 / $50.12 / $63.10
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $125.89 / $199.53
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$37.15 / $48.98 / $75.86
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$56.23 / $77.62 / $120.23
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $147.91 / $186.21
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $147.91 / $186.21
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $123.03 / $199.53
Providence
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$50.12 / $50.12 / $63.10
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $147.91 / $199.53
Providence
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$37.15 / $50.12 / $67.61
Providence
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$56.23 / $83.18 / $104.71
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $114.82 / $114.82
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $93.33 / $173.78
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$34.67 / $36.31 / $75.86
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$54.95 / $60.26 / $104.71