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Washington 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
$53.70 / $61.66 / $138.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.65 / $218.78 / $630.96
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$42.66 / $81.28 / $239.88
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$58.88 / $95.50 / $363.08
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.72 / $173.78 / $245.47
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$35.48 / $77.62 / $87.10
Ambetter
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$74.13 / $109.65 / $151.36
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$11.48 / $53.70 / $75.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.23 / $204.17 / $371.54
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$47.86 / $77.62 / $138.04
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$72.44 / $125.89 / $223.87
Kaiser Permanente
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$54.95 / $93.33 / $323.59
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $229.09 / $323.59
Kaiser Permanente
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$52.48 / $89.13 / $120.23
Kaiser Permanente
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$89.13 / $141.25 / $204.17
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $64.57
Pacific Source
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$75.86 / $93.33 / $95.50
Pacific Source
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$56.23 / $81.28 / $100.00
Pacific Source
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$85.11 / $123.03 / $154.88
Premera BCBS
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$63.10 / $63.10 / $63.10
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.18 / $263.03 / $338.84
Premera BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$63.10 / $104.71 / $144.54
Premera BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$97.72 / $158.49 / $208.93
Regence BlueShield
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$213.80 / $213.80 / $213.80
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.18 / $234.42 / $323.59
Regence BlueShield
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$64.57 / $95.50 / $128.82
Regence BlueShield
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$97.72 / $141.25 / $194.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.23 / $131.83 / $302.00
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$47.86 / $52.48 / $120.23
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$74.13 / $81.28 / $181.97
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.23 / $138.04 / $229.09
Wellpoint
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$46.77 / $53.70 / $89.13
Wellpoint
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$74.13 / $85.11 / $141.25