Limited breast ultrasound

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Ultrasound Breast, Limited

Payers reporting CPT 76642

Payer pricing summary

Low

$55

Average

$292

Median

$247

High

$865

Payer rate distribution

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#
1	Anthem fee schedule · outpatient · +37 other terms	182	$177	$129	$126	98%	5,409–5,445	$2 – $822
2	Cigna fee schedule · outpatient · +37 other terms	477	$194	$242	$168	69%	1,424–1,505	$22 – $2.2k
3	UnitedHealthcare fee schedule · outpatient · +41 other terms	760	$132	$158	$143	91%	1,166–1,274	$0 – $2.6k
4	Aetna fee schedule · outpatient · +40 other terms	693	$124	$262	$532	203%	945–1,062	$1 – $15.8k
5	Molina fee schedule · outpatient · +35 other terms	250	$95	$109	$57	52%	566–728	$1 – $557
6	Bcbs Al facility · other · outpatient · +5 other terms	5	$183	$194	$45	23%	435–462	$146 – $286
7	Medicare other · both · +22 other terms	46	$91	$127	$230	182%	350–467	$81 – $2.2k
8	Blue Cross Blue Shield fee schedule · outpatient · +36 other terms	512	$162	$174	$139	80%	212–347	$0 – $1.1k
9	Medica fee schedule · outpatient · +27 other terms	37	$152	$155	$119	77%	109–127	$26 – $922
10	Bcbs In other · both · +1 other terms	11	$318	$334	$50	15%	45–117	$211 – $422
11	Humana fee schedule · outpatient · +34 other terms	416	$97	$155	$185	120%	18–180	$1 – $1.5k
12	WellCare fee schedule · outpatient · +28 other terms	203	$94	$103	$51	49%	18	$25 – $641
13	Caresource fee schedule · outpatient · +23 other terms	77	$120	$137	$43	32%	3–30	$1 – $285
14	Optum fee schedule · outpatient · +24 other terms	71	$91	$196	$338	172%	2–20	$1 – $1.8k
15	Wellmark facility · fee schedule · both · +27 other terms	26	$216	$228	$156	69%	2–20	$47 – $732
16	Kaiser fee schedule · outpatient · +28 other terms	79	$115	$131	$91	69%	1–10	$32 – $683
17	Bcbs Mo professional · other · both · +2 other terms	1	$773	$773	—	—	1–10	$773 – $773
18	Bcbs Mt fee schedule · outpatient · +2 other terms	1	$166	$166	$51	31%	1–10	$94 – $202
19	Ambetter fee schedule · outpatient · +25 other terms	118	$151	$149	$74	50%	—	$29 – $678
20	MultiPlan fee schedule · outpatient · +23 other terms	97	$281	$392	$429	109%	—	$42 – $2.4k
21	Aetna Better Health fee schedule · outpatient · +21 other terms	91	$92	$94	$35	37%	—	$25 – $319
22	Tricare facility · fee schedule · outpatient · +22 other terms	90	$87	$115	$270	235%	—	$15 – $4.6k
23	Devoted facility · fee schedule · outpatient · +20 other terms	85	$83	$116	$355	307%	—	$17 – $4.9k
24	Highmark facility · fee schedule · outpatient · +22 other terms	69	$107	$136	$93	69%	—	$24 – $499
25	Oscar facility · fee schedule · outpatient · +24 other terms	57	$123	$114	$51	45%	—	$35 – $351

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