Limited ultrasound scan of 1 breast
Medicare pricing data for 19,361 providers across 52 states
Prices vary significantly by location — from $35 in West Virginia to $80 in Maryland. Where you get this procedure matters more than almost any other factor. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.
💡 What You Should Know
Limited ultrasound scan of 1 breast (HCPCS code 76642) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $52.49, but hospitals typically charge $209.06 — a 4.0x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $52.49, your out-of-pocket cost would be approximately $10.50. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 4.0x more than what Medicare allows for this procedure. Medicare actually pays $37.78 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Maryland | $80 | $209 | 377 | 20,624 | +52.3% |
| New Jersey | $74 | $283 | 599 | 24,567 | +40.2% |
| Arizona | $68 | $329 | 311 | 12,506 | +29.8% |
| District of Columbia | $67 | $213 | 89 | 4,626 | +27.8% |
| Nevada | $67 | $261 | 171 | 3,700 | +26.7% |
| California | $66 | $232 | 1,711 | 63,677 | +26.0% |
| Puerto Rico | $64 | $93 | 24 | 52 | +22.7% |
| Florida | $64 | $268 | 1,177 | 44,781 | +22.4% |
| New York | $64 | $252 | 1,060 | 37,143 | +22.2% |
| Colorado | $60 | $235 | 263 | 11,666 | +14.2% |
| Alaska | $58 | $354 | 44 | 1,972 | +11.1% |
| Connecticut | $57 | $187 | 305 | 8,695 | +9.2% |
| Rhode Island | $56 | $293 | 72 | 3,635 | +7.0% |
| Washington | $56 | $202 | 497 | 16,663 | +6.1% |
| Wyoming | $56 | $175 | 50 | 1,034 | +6.0% |
| New Mexico | $54 | $304 | 111 | 3,604 | +2.6% |
| Hawaii | $53 | $176 | 74 | 2,203 | +1.1% |
| Delaware | $52 | $131 | 59 | 3,384 | -0.4% |
| North Carolina | $52 | $216 | 861 | 25,428 | -1.3% |
| Virginia | $51 | $187 | 504 | 22,172 | -2.6% |
| Minnesota | $51 | $218 | 453 | 12,652 | -3.1% |
| Arkansas | $51 | $183 | 144 | 7,184 | -3.6% |
| Iowa | $50 | $191 | 271 | 8,077 | -4.6% |
| Texas | $50 | $240 | 1,065 | 30,321 | -4.8% |
| Kansas | $48 | $130 | 333 | 7,728 | -8.0% |
| Georgia | $48 | $216 | 608 | 20,041 | -8.7% |
| Tennessee | $48 | $206 | 639 | 17,917 | -9.3% |
| New Hampshire | $45 | $220 | 133 | 3,222 | -13.9% |
| Alabama | $45 | $131 | 336 | 7,603 | -14.5% |
| Illinois | $44 | $204 | 730 | 33,612 | -15.9% |
| Massachusetts | $43 | $158 | 527 | 23,089 | -17.3% |
| Montana | $43 | $133 | 63 | 2,101 | -17.9% |
| Wisconsin | $43 | $353 | 602 | 10,921 | -18.2% |
| Oregon | $43 | $143 | 238 | 8,375 | -18.5% |
| Nebraska | $43 | $163 | 257 | 5,593 | -18.5% |
| South Dakota | $41 | $136 | 107 | 2,523 | -22.2% |
| Pennsylvania | $41 | $162 | 848 | 33,503 | -22.4% |
| Louisiana | $40 | $184 | 298 | 7,829 | -23.0% |
| South Carolina | $40 | $171 | 209 | 11,332 | -23.8% |
| Kentucky | $40 | $123 | 280 | 8,332 | -24.7% |
| Utah | $39 | $127 | 151 | 3,158 | -25.3% |
| Indiana | $39 | $168 | 357 | 12,270 | -25.6% |
| Michigan | $39 | $143 | 515 | 17,942 | -25.7% |
| Missouri | $39 | $147 | 394 | 16,271 | -26.2% |
| Mississippi | $38 | $126 | 160 | 5,627 | -27.3% |
| North Dakota | $38 | $148 | 98 | 2,733 | -28.0% |
| Oklahoma | $37 | $170 | 185 | 8,919 | -29.2% |
| Ohio | $37 | $175 | 549 | 22,501 | -30.1% |
| Idaho | $36 | $173 | 92 | 2,800 | -31.7% |
| Maine | $36 | $132 | 179 | 3,103 | -31.9% |
| Vermont | $35 | $198 | 36 | 1,440 | -32.5% |
| West Virginia | $35 | $151 | 132 | 2,614 | -34.2% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber