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Maryland 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
$27.54 / $27.54 / $27.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.57 / $89.13 / $275.42
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$25.70 / $33.11 / $125.89
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$165.96 / $295.12 / $741.31
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$34.67 / $47.86 / $125.89
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.67 / $75.86 / $104.71
CareFirst
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$30.90 / $30.90 / $39.81
CareFirst
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$43.65 / $48.98 / $54.95
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$51.29 / $51.29 / $51.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $102.33 / $181.97
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$24.55 / $38.90 / $72.44
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$34.67 / $61.66 / $117.49
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.28 / $93.33 / $158.49
Kaiser Permanente
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$33.88 / $38.90 / $56.23
Kaiser Permanente
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$47.86 / $56.23 / $102.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.79 / $97.72 / $181.97
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$26.30 / $35.48 / $63.10
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$45.71 / $63.10 / $112.20
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.86 / $100.00 / $117.49
Wellpoint
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$31.62 / $40.74 / $48.98
Wellpoint
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$43.65 / $60.26 / $70.79