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New York 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
$85.11 / $186.21 / $575.44
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$25.70 / $35.48 / $75.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $100.00 / $363.08
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$28.84 / $56.23 / $144.54
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$66.07 / $173.78 / $630.96
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$42.66 / $60.26 / $177.83
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.10 / $75.86 / $141.25
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$26.92 / $47.86 / $64.57
Ambetter
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$89.13 / $104.71 / $223.87
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $93.33 / $177.83
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$28.84 / $34.67 / $64.57
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$120.23 / $141.25 / $251.19
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$51.29 / $60.26 / $107.15
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.86 / $75.86 / $114.82
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.86 / $75.86 / $123.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$114.82 / $162.18 / $213.80
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$7.94 / $37.15 / $52.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.18 / $123.03 / $269.15
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$26.30 / $47.86 / $104.71
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$43.65 / $77.62 / $173.78
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.67 / $69.18 / $186.21
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $107.15 / $177.83
Emblem Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$31.62 / $46.77 / $67.61
Emblem Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$53.70 / $72.44 / $114.82
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.92 / $26.92 / $26.92
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.10 / $109.65 / $194.98
Excellus BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$23.99 / $42.66 / $74.13
Excellus BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$39.81 / $67.61 / $120.23
Fidelis
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.54 / $57.54 / $89.13
Fidelis
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$23.99 / $30.20 / $38.02
Fidelis
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$144.54 / $144.54 / $154.88
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.88 / $169.82 / $933.25
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.13 / $97.72 / $158.49
Highmark BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$38.02 / $44.67 / $69.18
Highmark BCBS
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$61.66 / $147.91 / $213.80
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.48 / $104.71 / $53,703.18
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $120.23 / $190.55
MVP Health Care
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$38.02 / $46.77 / $72.44
MVP Health Care
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$61.66 / $72.44 / $117.49
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$173.78 / $204.17 / $251.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.57 / $85.11 / $190.55
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$23.44 / $33.11 / $70.79
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$40.74 / $53.70 / $117.49
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.92 / $61.66 / $117.49
Univera
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$25.70 / $38.02 / $54.95
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.10 / $100.00 / $199.53
Univera
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$26.30 / $41.69 / $81.28
Univera
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$39.81 / $61.66 / $123.03