go back

New Hampshire rates for HCPCS 76642

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

Facilitymedian $263 · 10th–90th $49$6760%5%10%10th90th$263Professionalmedian $76 · 10th–90th $35$2000%5%10%10th90th$76$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
$91.20 / $407.38 / $691.83
Aetna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$34.67 / $34.67 / $74.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $89.13 / $213.80
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$28.84 / $60.26 / $95.50
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$54.95 / $147.91 / $501.19
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$43.65 / $61.66 / $138.04
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $89.13 / $275.42
Ambetter
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$25.12 / $34.67 / $104.71
Ambetter
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$100.00 / $131.83 / $302.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $467.74 / $524.81
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $125.89 / $173.78
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$31.62 / $46.77 / $66.07
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$125.89 / $190.55 / $263.03
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$52.48 / $75.86 / $107.15
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $416.87 / $524.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $138.04 / $229.09
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$35.48 / $54.95 / $89.13
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$56.23 / $89.13 / $151.36
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $141.25 / $223.87
Harvard Pilgrim
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$37.15 / $52.48 / $87.10
Harvard Pilgrim
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$61.66 / $93.33 / $138.04
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $131.83 / $302.00
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$34.67 / $48.98 / $97.72
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$58.88 / $77.62 / $151.36
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $77.62 / $85.11
Well Sense
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$22.39 / $28.18 / $30.90