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Maryland rates for HCPCS 76801

Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$40.31 / $54.99 / $57.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.22 / $142.88 / $497.00
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$40.90 / $66.20 / $181.00
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$63.91 / $81.31 / $175.29
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$118.77 / $138.38 / $177.14
CareFirst
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$46.80 / $52.00 / $72.54
CareFirst
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$73.09 / $86.39 / $109.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.98 / $147.38 / $274.94
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$36.18 / $57.15 / $105.18
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$56.43 / $90.76 / $172.46
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.21 / $149.72 / $252.63
Kaiser Permanente
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$47.15 / $57.07 / $97.92
Kaiser Permanente
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$72.95 / $91.19 / $133.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.20 / $124.51 / $304.29
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$37.68 / $48.88 / $90.81
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$62.94 / $80.69 / $136.62
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.98 / $138.24 / $171.75
Wellpoint
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$40.09 / $54.35 / $68.75
Wellpoint
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$61.89 / $83.89 / $104.75