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Arizona rates for HCPCS 76513

Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) B-scan or high resolution biomicroscopy, unilateral or bilateral

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$109.65 / $138.04 / $151.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.66 / $87.10 / $275.42
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$25.70 / $33.11 / $131.83
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$173.78 / $295.12 / $407.38
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$33.88 / $48.98 / $162.18
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.98 / $54.95 / $58.88
Ambetter
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$72.44 / $72.44 / $72.44
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.10 / $70.79 / $123.03
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$25.70 / $28.84 / $50.12
BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$38.02 / $42.66 / $74.13
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$7.76 / $36.31 / $51.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.07 / $102.33 / $177.83
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$26.92 / $38.90 / $69.18
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$37.15 / $61.66 / $109.65
Medica
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$74.13 / $144.54 / $144.54
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.18 / $102.33 / $588.84
Medica
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$32.36 / $37.15 / $338.84
Medica
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$48.98 / $64.57 / $354.81
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $97.72 / $144.54
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$31.62 / $36.31 / $53.70
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$48.98 / $63.10 / $91.20