Ultrasound
Hospital for Special Surgery
What goes into a price?
Prices across providers
Self pay or cash prices vary by provider when paying out of pocket without insurance benefits. The chart shows you how the lowest and highest amounts providers charge for this service if you were paying without insurance benefits. If you're uninsured or not submitting a claim to insurance, you also have the right to a Good Faith Estimate under federal law. Contact the provider for a copy of your Good Faith Estimate or to better understand payment options available to you.
Procedures included in this package
This list includes the services and fees bundled into the Ultrasound Standard Service Package (SSP RA008). The final price for the procedure will depend on which services your provider ultimately performs, your insurance plan and your medical benefits.
| Code | Code Type | Description |
|---|---|---|
| HCPCS 93656 | Base Code | Ultrasound |
| RC 0272 | Facility Fee | Medical/Surgical Supplies and Devices (Also see 062X, an extension of 027X) - Sterile |
| RC 0250 | Facility Fee | Pharmacy (Also see 063X, an extension of 250X) - General |
| RC 0402 | Facility Fee | Other Imaging Services - Ultrasound |
| RC 0402 | Facility Fee | Other Imaging Services - Ultrasound |
| RC 0402 | Facility Fee | Other Imaging Services - Ultrasound |
| RC 0402 | Facility Fee | Other Imaging Services - Ultrasound |
| RC 0402 | Facility Fee | Other Imaging Services - Ultrasound |
| RC 0402 | Facility Fee | Other Imaging Services - Ultrasound |
| RC 0402 | Facility Fee | Other Imaging Services - Ultrasound |
| RC 0636 | Facility Fee | Pharmacy - Extension of 025X - Drugs requiring detailed coding |
| HCPCS C1894 | Facility Fee | Insertion of Non-intracardiac Diagnostic/Therapeutic Device/Sheath |
| HCPCS J1644 | Facility Fee | Intramuscular Injection of Anti-coagulant Heparin 1000 Units |
| HCPCS J3010 | Facility Fee | Intramuscular injection of fentanyl citrate, 0.1mg |
| HCPCS C1730 | Facility Fee | Diagnostic Electrophysiology Catheter, Up to 19 Electrodes |
| RC 0370 | Facility Fee | Anesthesia - General |
| HCPCS J2704 | Facility Fee | Intramuscular injection of 10mg propofol |
| HCPCS C1732 | Facility Fee | Diagnostic/ablation Catheter for 3d/Vector Electrophysiology Mapping |
| HCPCS J2405 | Facility Fee | Intramuscular injection of ondansetron hydrochloride, 1mg |
| RC 0710 | Facility Fee | Recovery Room - General |
| RC 0481 | Facility Fee | Cardiology - Cardiac cath lab |
| RC 0305 | Facility Fee | Laboratory - Hematology |
| HCPCS J2250 | Facility Fee | Intramuscular injection of 1mg midazolam hydrochloride |
| RC 0480 | Facility Fee | Cardiology - General |
| HCPCS C1759 | Facility Fee | Intracardiac Echocardiography Using Inserted Catheter |
| RC 0278 | Facility Fee | Medical/Surgical Supplies and Devices (Also see 062X, an extension of 027X) - Other implants |
| HCPCS J2720 | Facility Fee | Intramuscular Injection of 10mg Protamine Sulfate |
| RC 0301 | Facility Fee | Laboratory - Chemistry |
| HCPCS 00530 | Professional Fee | Anesthesia for Intrathoracic Surgery or Operations |
| RC 0270 | Optional Fee | Medical/Surgical Supplies and Devices (Also see 062X, an extension of 027X) - General |