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Wisconsin rates for HCPCS 76642

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

Facilitymedian $501 · 10th–90th $148$7760%5%10%10th90th$501Professionalmedian $107 · 10th–90th $38$5010%5%10th90th$107$10.0$50.0$200.0$1.0K$5.0K

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
$288.40 / $549.54 / $776.25
Aetna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$34.67 / $56.23 / $83.18
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $141.25 / $512.86
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$30.20 / $72.44 / $338.84
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$77.62 / $489.78 / $1,621.81
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$43.65 / $61.66 / $269.15
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $128.82 / $389.05
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$31.62 / $48.98 / $147.91
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$123.03 / $190.55 / $616.60
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$51.29 / $79.43 / $239.88
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46.77 / $75.86 / $134.90
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $74.13 / $123.03
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $269.15 / $426.58
Cigna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$85.11 / $100.00 / $158.49
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $245.47 / $346.74
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$38.02 / $95.50 / $131.83
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$57.54 / $151.36 / $213.80
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$74.13 / $169.82 / $457.09
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $177.83 / $234.42
DeanCare
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$58.88 / $67.61 / $89.13
DeanCare
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$229.09 / $263.03 / $354.81
DeanCare
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$95.50 / $109.65 / $147.91
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $251.19 / $562.34
Medica
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$147.91 / $147.91 / $295.12
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $165.96 / $549.54
Medica
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$36.31 / $77.62 / $213.80
Medica
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$380.19 / $562.34 / $794.33
Medica
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$54.95 / $97.72 / $338.84
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $70.79
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $131.83 / $131.83
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $123.03 / $338.84
Network Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$40.74 / $46.77 / $123.03
Network Health
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$66.07 / $75.86 / $208.93
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $194.98 / $363.08
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $549.54 / $549.54
Quartz
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$75.86 / $204.17 / $204.17
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $426.58 / $549.54
Quartz
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$39.81 / $165.96 / $204.17
Quartz
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$64.57 / $257.04 / $338.84
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $218.78 / $218.78
Security Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$85.11 / $85.11 / $85.11
Security Health
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$134.90 / $134.90 / $134.90
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $302.00 / $537.03
Security Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$83.18 / $97.72 / $154.88
Security Health
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$131.83 / $154.88 / $194.98
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $104.71 / $302.00
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $208.93 / $645.65
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$56.23 / $100.00 / $245.47
United
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$72.44 / $138.04 / $398.11