go back

Montana rates for HCPCS 76642

Us Breast Uni Real Time With Image Limited

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$88.05 / $277.58 / $1,130.91
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.01 / $94.71 / $417.00
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$30.44 / $44.89 / $157.00
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$111.06 / $528.51 / $832.00
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$50.56 / $59.68 / $238.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$514.54 / $77,999.99 / $94,999.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.08 / $134.08 / $134.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$81.92 / $134.08 / $311.27
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$50.48 / $50.48 / $62.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.87 / $134.08 / $190.51
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$37.29 / $50.48 / $71.09
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$56.38 / $83.60 / $112.32
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$82.12 / $111.95 / $165.75
Providence
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$50.48 / $50.48 / $62.40
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.03 / $146.66 / $228.22
Providence
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$40.22 / $50.48 / $58.02
Providence
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$64.75 / $83.60 / $95.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.14 / $92.92 / $156.55
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$34.65 / $36.14 / $60.86
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$54.49 / $56.78 / $95.69