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
HC US Breat Limited Diagnostic-Lt
Utica, NY
See all hospitals reporting CPT 76642 →Price type
MVHS, Inc.’s median price of $106 is 34% below the median hospital's median price ($161), higher than 24% of the 2,558 hospitals reporting CPT 76642. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 13 payers, 42 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 | Excellus excellus bcbs medicaid fee schedule · outpatient | $27 | $27 | — | — | — | $27 – $27 |
| 2 | Excellus excellus bcbs medicaid hmo fee schedule · outpatient | $27 | $27 | — | — | — | $27 – $27 |
| 3 | Molina misc medicaid mco fee schedule · outpatient | $27 | $27 | — | — | — | $27 – $27 |
| 4 | UnitedHealthcare uhc essential plan fee schedule · outpatient | $27 | $27 | — | — | — | $27 – $27 |
| 5 | UnitedHealthcare uhc medicaid fee schedule · outpatient | $27 | $27 | — | — | — | $27 – $27 |
| 6 | WellCare hb mvhs wellcare medicaid fee schedule · outpatient | $27 | $27 | — | — | — | $27 – $27 |
| 7 | Humana humana military percent of total billed charges · bothfrom % of charges | $37 | $37 | — | — | — | $37 – $37 |
| 8 | Tricare humana military percent of total billed charges · bothfrom % of charges | $37 | $37 | — | — | — | $37 – $37 |
| 9 | UnitedHealthcare uhc medicare advantage percent of total billed charges · bothfrom % of charges | $39 | $39 | $17 | 45% | — | $21 – $56 |
| 10 | WellCare wellcare fee schedule · outpatient | $49 | $49 | $22 | 45% | — | $27 – $70 |
| 11 | Humana choicecare fee schedule · both | $55 | $55 | $24 | 44% | — | $31 – $79 |
| 12 | Humana humana medicare advantage fee schedule · both | $55 | $55 | $24 | 44% | — | $31 – $79 |
| 13 | Medicare medicare fee schedule · both | $55 | $55 | $25 | 45% | — | $31 – $80 |
| 14 | WellCare wellcare fee schedule · both | $57 | $57 | $25 | 45% | — | $32 – $82 |
| 15 | WellCare wellcare fee schedule · inpatient | $57 | $57 | $25 | 45% | — | $32 – $82 |
| 16 | Humana humana military fee schedule · both | $75 | $75 | — | — | — | $75 – $75 |
| 17 | Tricare humana military fee schedule · both | $75 | $75 | — | — | — | $75 – $75 |
| 18 | Blue Cross Blue Shield excellus bcbs federal fee schedule · both | $77 | $77 | $34 | 44% | — | $43 – $110 |
| 19 | Cigna mvp hmo/ppo fee schedule · both | $77 | $77 | $34 | 45% | — | $43 – $112 |
| 20 | UnitedHealthcare uhc empire plan fee schedule · outpatient | $86 | $86 | — | — | — | $86 – $86 |
| 21 | Humana humana military other · outpatient | $99 | $99 | — | — | — | $99 – $99 |
| 22 | Tricare humana military other · outpatient | $99 | $99 | — | — | — | $99 – $99 |
| 23 | Medical Mutual worker's compensation and no fault fee schedule · outpatient | $106 | $106 | — | — | — | $106 – $106 |
| 24 | Excellus excellus bcbs medicare advantage other · outpatient | $109 | $109 | — | — | — | $109 – $109 |
| 25 | Humana humana medicare advantage other · outpatient | $109 | $109 | — | — | — | $109 – $109 |
Last updated: Aug 7, 2026
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