RC 402
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.
Original text from hospital filings
Limited ultrasound scan of 1 breast
Clearlake, CA
See all hospitals reporting RC 402 →Price type
Adventist Health Clearlake Hospital Inc’s median price of $422 is 41% above the median hospital's median price ($300), higher than 71% of the 1,982 hospitals reporting RC 402. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 9 payers, 19 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | ||||
|---|---|---|---|---|
| 1 | Medicaid medi-cal fee schedule · outpatient | $99.17 | $139.24 | $14.52 – $1,337 |
| 2 | Blue Cross Blue Shield blue shield mcr adv percent of total billed charges · outpatientfrom % of charges | $154.77 | $169.53 | $6.09 – $466.62 |
| 3 | Blue Cross Blue Shield tricare blue shield- all plans percent of total billed charges · outpatientfrom % of charges | $154.77 | $169.53 | $6.09 – $466.62 |
| 4 | Kaiser kaiser mcr adv percent of total billed charges · outpatientfrom % of charges | $154.77 | $169.53 | $6.09 – $466.62 |
| 5 | Blue Cross Blue Shield blue cross mcr adv percent of total billed charges · outpatientfrom % of charges | $160.96 | $176.31 | $6.33 – $485.28 |
| 6 | UnitedHealthcare uhc mcr adv percent of total billed charges · outpatientfrom % of charges | $170.25 | $186.48 | $6.70 – $513.28 |
| 7 | Blue Cross Blue Shield blue cross exchange fee schedule · outpatient | $361.24 | $393.97 | $16.59 – $933.56 |
| 8 | Blue Cross Blue Shield blue cross non-mcs fee schedule · outpatient | $401.37 | $437.74 | $18.43 – $1,037 |
| 9 | Blue Cross Blue Shield blue cross mcs - all other plans fee schedule · outpatient | $481.64 | $525.29 | $22.11 – $1,245 |
| 10 | Aetna aetna- all plans percent of total billed charges · outpatientfrom % of charges | $550.69 | $603.20 | $21.67 – $1,660 |
| 11 | Blue Cross Blue Shield blue shield epn - all other plans percent of total billed charges · outpatientfrom % of charges | $566.02 | $619.99 | $22.27 – $1,707 |
| 12 | Blue Cross Blue Shield blue shield non-epn percent of total billed charges · outpatientfrom % of charges | $566.02 | $619.99 | $22.27 – $1,707 |
| 13 | UnitedHealthcare uhc jll percent of total billed charges · outpatientfrom % of charges | $583.93 | $639.61 | $22.98 – $1,760 |
| 14 | First Health first health- all plans percent of total billed charges · outpatientfrom % of charges | $589.60 | $645.83 | $23.20 – $1,778 |
| 15 | UnitedHealthcare uhc all payer - all other plans percent of total billed charges · outpatientfrom % of charges | $614.66 | $673.27 | $24.19 – $1,853 |
| 16 | Humana humana- all plans percent of total billed charges · outpatientfrom % of charges | $626.45 | $686.19 | $24.65 – $1,889 |
| 17 | Phcs phcs- all plans percent of total billed charges · outpatientfrom % of charges | $626.45 | $686.19 | $24.65 – $1,889 |
| 18 | Cigna cigna- all plans percent of total billed charges · outpatientfrom % of charges | $663.30 | $726.55 | $26.10 – $2,000 |
| 19 | Kaiser kaiser- all other plans percent of total billed charges · outpatientfrom % of charges | $663.30 | $726.55 | $26.10 – $2,000 |
Last updated: Jul 29, 2026
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