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Pennsylvania 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
$42.00 / $50.22 / $92.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.06 / $173.89 / $545.00
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$41.58 / $66.53 / $181.00
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$58.13 / $81.31 / $131.31
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.70 / $144.41 / $194.93
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$35.63 / $62.48 / $86.40
Ambetter
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$75.50 / $102.01 / $115.94
AmeriHealth
Facility/Professional
Professional
Modifier
Low / Median / High Price
$150.51 / $163.13 / $267.38
AmeriHealth
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$54.50 / $70.31 / $125.93
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$113.40 / $186.94 / $291.63
Capital Blue Cross
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$46.97 / $76.11 / $116.35
Capital Blue Cross
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$66.43 / $109.62 / $175.30
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$53.62 / $53.62 / $53.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$94.62 / $154.26 / $240.05
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$37.75 / $60.11 / $94.58
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$57.73 / $94.22 / $147.44
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$135.52 / $160.78 / $345.28
Emblem Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$53.21 / $67.77 / $132.94
Emblem Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$82.93 / $106.62 / $212.35
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.19 / $142.44 / $199.98
Highmark BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$51.04 / $59.39 / $79.63
Highmark BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$78.20 / $82.48 / $102.90
Independence Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$132.32 / $161.84 / $267.38
Independence Blue Cross
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$49.43 / $70.31 / $125.93
Martin's Point
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$42.00 / $60.06 / $135.58
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.11 / $178.90 / $519.00
Martin's Point
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$42.60 / $70.16 / $168.00
Martin's Point
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$61.59 / $88.99 / $179.71
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.69 / $108.00 / $210.31
Priority Health
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$53.62 / $53.62 / $53.62
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.77 / $153.56 / $240.05
Priority Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$38.50 / $60.11 / $94.58
Priority Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$58.57 / $93.89 / $144.77
UPMC Health Plan
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$46.47 / $46.47 / $57.00
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.61 / $114.13 / $133.00
UPMC Health Plan
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$45.36 / $46.47 / $57.00
UPMC Health Plan
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$66.19 / $67.65 / $76.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.18 / $132.76 / $224.89
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$39.15 / $54.32 / $92.51
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$58.65 / $79.72 / $130.43