CPT 76642 · professional fee

Ultrasound breast limited (CPT 76642): negotiated rates by payer and state

What UnitedHealthcare, Aetna, Cigna and Blue Cross Blue Shield pay for CPT 76642, from their published in-network rate files.

Diagnostic radiologySnapshot Aug 2026Professional fee only

National summary

Commercial in-network, four payers combined, professional fee

Median rate

$120

P10 to P90: $77 to $221

vs Medicare

144%

non-facility rate $83.50

Payer spread

1.40×

UHC $137 vs Aetna $98

State spread

2.6×

AK $197 to OK $76

5,795 sampled providers7,094 TINs51 statesSample-based · how this is calculated

What the data shows

Generated from this code's own numbers

UnitedHealthcare has the highest median for CPT 76642 in the files analyzed, at $137, 40% above Aetna ($98), the lowest of the 4 payers shown.

The state spread is 2.6×: Alaska has the highest median at $197 and Oklahoma the lowest at $76, a gap larger than the gap between the highest and lowest payer.

Commercial rates run 144% of the Medicare non-facility rate ($83.50), which ranks 131st of 228 tracked codes by commercial-to-Medicare ratio.

Rates are tightest within Aetna (interquartile range $54) and widest within UnitedHealthcare ($88).

This is a top-30 code for diagnostic radiology by Medicare allowed dollars, so it carries real revenue weight for that specialty.

Rates by payer

Median of per-provider median rates, with interquartile range

Payer	Median	P25	P75	vs national	Rank	Providers	Position
UnitedHealthcare	$137	$101	$189	+14%	1	3,939	164% of Medicare
Cigna	$128	$105	$179	+7%	2	4,580	154% of Medicare
Blue Cross Blue Shield	$117	$87	$155	-2%	3	4,565	140% of Medicare
Aetna	$98	$82	$136	-19%	4	3,782	117% of Medicare

Rate distribution

Box = P25 to P75, whiskers = P10 to P90, tick = median, dashed line = Medicare non-facility ($83.50)

Rates by state

Median across payers · 51 states with enough data

Rank	State	Median	vs national	Highest payer	Lowest payer	Providers
1	Alaska	$197	+64%	Aetna	Cigna	61
2	Washington	$184	+53%	Aetna	BCBS	117
3	Wisconsin	$175	+46%	UHC	Cigna	122
4	South Dakota	$167	+38%	Cigna	Aetna	85
5	Wyoming	$166	+38%	BCBS	Aetna	41
6	Nebraska	$157	+31%	Cigna	Aetna	120
7	Iowa	$153	+27%	Cigna	Aetna	100
8	North Dakota	$149	+23%	BCBS	Aetna	86
9	Oregon	$148	+23%	UHC	BCBS	106
10	North Carolina	$146	+22%	Cigna	Aetna	121
11	Colorado	$139	+16%	UHC	Aetna	124
12	Ohio	$138	+15%	UHC	Cigna	128
13	Idaho	$137	+14%	BCBS	UHC	124
14	Montana	$134	+11%	Aetna	UHC	69
15	Georgia	$126	+5%	Cigna	Aetna	127
16	Utah	$126	+5%	UHC	Cigna	122
17	Virginia	$123	+2%	UHC	BCBS	120
18	West Virginia	$122	+2%	UHC	BCBS	117
19	Hawaii	$122	+1%	Cigna	BCBS	106
19	New Hampshire	$122	+1%	UHC	Aetna	127
21	Missouri	$122	+1%	UHC	Aetna	123
22	Vermont	$122	+1%	UHC	Aetna	63
23	New Jersey	$121	+1%	UHC	Aetna	126
24	Tennessee	$121	+0%	BCBS	Aetna	127
25	Maine	$120	+0%	UHC	BCBS	127
25	Massachusetts	$120	+0%	UHC	Aetna	118
25	Connecticut	$120	+0%	UHC	Aetna	124
28	Michigan	$119	-1%	Cigna	Aetna	116
29	South Carolina	$119	-1%	Cigna	Aetna	111
30	Pennsylvania	$115	-4%	UHC	Aetna	120
31	Arkansas	$115	-5%	UHC	BCBS	117
32	Minnesota	$114	-5%	UHC	Aetna	123
33	Mississippi	$113	-6%	BCBS	UHC	112
34	California	$113	-6%	UHC	Aetna	107
35	Kansas	$111	-8%	BCBS	Aetna	116
36	Rhode Island	$110	-8%	UHC	Aetna	127
37	Louisiana	$110	-9%	Cigna	BCBS	121
38	District of Columbia	$107	-11%	UHC	BCBS	133
38	Nevada	$107	-11%	BCBS	Cigna	123
40	Florida	$107	-11%	Cigna	Aetna	108
41	Delaware	$106	-12%	UHC	Aetna	98
42	New York	$104	-13%	UHC	Aetna	128
43	Maryland	$104	-13%	UHC	BCBS	106
44	Arizona	$104	-14%	Cigna	Aetna	113
45	New Mexico	$103	-14%	UHC	BCBS	123
46	Illinois	$100	-17%	UHC	BCBS	124
47	Kentucky	$98	-19%	Cigna	BCBS	134
47	Alabama	$98	-19%	Aetna	BCBS	126
49	Indiana	$94	-22%	UHC	Aetna	135
50	Texas	$92	-24%	Cigna	BCBS	133
51	Oklahoma	$76	-36%	UHC	BCBS	110

Frequently asked questions

Answers use this page's data

Which payer has the highest median rate for CPT 76642?

In the files we analyzed, UnitedHealthcare, at a median of $137 across 3,939 sampled providers. Aetna is lowest at $98, 40% lower than the highest.

How does the commercial rate compare with Medicare?

The national median is 144% of the 2026 Medicare non-facility rate of $83.50.

Which state has the highest median for CPT 76642?

Alaska has the highest median at $197; Oklahoma has the lowest at $76.

Is this a professional fee?

These are professional (physician) fees only. Facility, device and implant payments are priced separately and are not included.

How current is this data?

It is the August 2026 snapshot of each payer's in-network rate file. Sources and filters are listed in the methodology below.

Methodology

How these numbers are calculated

Source: in-network negotiated-rate files published under the federal Transparency in Coverage rule, August 2026 snapshot: UnitedHealthcare Choice plans (74 files); Aetna commercial plans (70 files); Cigna national PPO (1 files); BCBS licensees' own-network files (5,387 files). Payer comparisons describe these files, not each payer's entire book of business.
Sample: rates come from a random sample of up to 150 providers per state and specialty. Counts on this page are sampled providers and TINs, not totals.
Which providers count: only providers in a specialty relevant to the code, because a rate in a payer file attaches to a provider group and is listed under every provider in that group.
Filters: fee-for-service, professional billing class, no modifier, negotiated or fee-schedule dollar rates. Rates outside 1% to 1,000% of the Medicare rate are excluded.
Statistic: one median rate per provider, then percentiles across providers. A cell is shown only with at least 15 sampled providers and 4 TINs.
Medicare benchmark: CY2026 national physician fee schedule, non-QPP conversion factor, unadjusted for locality. Where the non-facility rate is more than twice the facility rate (office rates that include device or supply cost), the facility rate is used so comparisons are like for like.

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