Price lookup
Search a service and see its price with and without membership.
Member fee schedule, version 1
416 services
| Service | Code | Price without membership | Essential | Plus | Premier |
|---|---|---|---|---|---|
| Abdomen Complete Ultrasound | 76700 | $100.00 | $90.00 | $85.00 | $80.00 |
| Abdomen Limited Ultrasound | 76705 | $100.00 | $90.00 | $85.00 | $80.00 |
| Abdominal Aorta to Screen AAA Ultrasound | 76706 | $100.00 | $90.00 | $85.00 | $80.00 |
| Abdominal / Pelvic / Scrotal Vessel Duplex – Complete Ultrasound | 93975 | $150.00 | $135.00 | $127.50 | $120.00 |
| Abdominal / Pelvic / Scrotal Vessel Duplex – Limited Ultrasound | 93976 | $150.00 | $135.00 | $127.50 | $120.00 |
| Abdominal Wall – Mass / Hernia Evaluation Ultrasound | 76880 | $100.00 | $90.00 | $85.00 | $80.00 |
| Aorta / IVC / Iliac Vessel Duplex – Complete Ultrasound | 93978 | $150.00 | $135.00 | $127.50 | $120.00 |
| Aorta / IVC / Iliac Vessel Duplex – Limited Ultrasound | 93979 | $150.00 | $135.00 | $127.50 | $120.00 |
| Chest Ultrasound | 76604 | $100.00 | $90.00 | $85.00 | $80.00 |
| Complete Breast Ultrasound | 76641 | $100.00 | $90.00 | $85.00 | $80.00 |
| Detailed OB – Additional Fetus Ultrasound | 76812 | $150.00 | $135.00 | $127.50 | $120.00 |
| Detailed OB – Single Fetus Ultrasound | 76811 | $200.00 | $180.00 | $170.00 | $160.00 |
| Doppler Echo for Complete Study Ultrasound | 93320 | $150.00 | $135.00 | $127.50 | $120.00 |
| Duplex, Extracranial Arteries Bilateral, Complete Study Ultrasound | 93880 | $150.00 | $135.00 | $127.50 | $120.00 |
| Duplex, Extracranial Arteries Unilateral, Limited Study Ultrasound | 93882 | $150.00 | $135.00 | $127.50 | $120.00 |
| Duplex, Intracranial Arteries Complete Study Ultrasound | 93886 | $150.00 | $135.00 | $127.50 | $120.00 |
| Duplex, Intracranial Arteries Limited Study Ultrasound | 93888 | $150.00 | $135.00 | $127.50 | $120.00 |
| Duplex, Lower Extremity Arteries, Complete & Bilateral Ultrasound | 93925 | $150.00 | $135.00 | $127.50 | $120.00 |
| Duplex, Lower Extremity Arteries, Limited & Unilateral Ultrasound | 93926 | $150.00 | $135.00 | $127.50 | $120.00 |
| Echocardiogram – Complete / M-Mode Ultrasound | 93307 | $150.00 | $135.00 | $127.50 | $120.00 |
“—”: the plan has no special price for that service; its benefits or the price without membership apply.
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