Ultrasound, breast, unilateral with image documentation (sonomamography)
| 2020 CPT/HCPCS | 76641 |
| Negotiated Private Fee | $106.00 |
| Prossam | $83.00 |
| Champva | $109.50 |
| First Medical | $60.00 |
| First Medical Vital | $76.73 |
| Plan de Salud Menonita | $75.00 |
| Menonita Vital | $99.65 |
| Humana Gold plus/ Gold choice | Ambulatory Payment classification (APC) |
| Humana | $58.00 |
| Mapfre | $35.00 |
| Mcs Classicare | $64.96 |
| MCS Life | $64.96 |
| Medicare | Ambulatory Payment classification (APC) |
| MMM | $98.66 |
| MMM Vital | $77.50 |
| Panamerican Life | Not Covered |
| PMC | $98.66 |
| Tricare | $107.90 |
| Triple S Salud | $60.00 |
| Triple S Vital | $53.00 |
| Triple S Advantage | Ambulatory Payment classification (APC) |
| Negotiated Minimum Charge | $35.00 |
| Negotiated Maximus Charge | $109.50 |
| Discounted Cash Price | $84.80 |
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