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Payers and negotiated rates for CPT 76641-LT | medprice.ai

CPT 76641-LT

""US BREAST COMPLETE LEFT""

Payer pricing summary

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Low

$33

Average

$166

Median

$175

High

$366

Payer rate distribution

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Filter by billing methodology

All methodologies Case rate 0 Fee schedule 7 Per diem 4 Percent of billed charges 8 Other 0

Filter by billing class

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#
1	Aetna fee schedule · both · +3 other terms	1	$33	$33	—	—	—	$33 – $33
2	Amerihealth Caritas facility · percent of total billed charges · outpatientfrom % of charges	1	$130	$130	$2	1%	—	$128 – $131
3	Blue Cross Blue Shield facility · per diem · inpatient · +2 other terms	1	$457	$457	—	—	—	$457 – $457
4	Cigna fee schedule · both · +3 other terms	1	$33	$33	—	—	—	$33 – $33
5	Highmark facility · percent of total billed charges · outpatientfrom % of charges	1	$263	$263	$82	31%	—	$127 – $347
6	Humana fee schedule · both · +4 other terms	1	$33	$33	—	—	—	$33 – $33
7	MultiPlan facility · percent of total billed charges · inpatientfrom % of charges · +1 other terms	1	$366	$366	—	—	—	$366 – $366
8	Optum fee schedule · both	1	$33	$33	—	—	—	$33 – $33
9	Tricare fee schedule · both	1	$33	$33	—	—	—	$33 – $33
10	UnitedHealthcare fee schedule · both · +4 other terms	1	$33	$33	—	—	—	$33 – $33

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← Hospitals reporting CPT 76641-LT · Snapshot 20261113T090226Z-3ce6c0b8