go back

New Hampshire rates for HCPCS 76805

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$47.86 / $69.18 / $177.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.20 / $204.17 / $467.74
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$41.69 / $89.13 / $151.36
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$74.13 / $104.71 / $302.00
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.15 / $151.36 / $331.13
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$54.95 / $69.18 / $154.88
Ambetter
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$173.78 / $173.78 / $177.83
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $199.53 / $275.42
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$46.77 / $69.18 / $97.72
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$89.13 / $131.83 / $177.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.88 / $245.47 / $407.38
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$54.95 / $85.11 / $138.04
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$104.71 / $165.96 / $263.03
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.88 / $229.09 / $363.08
Harvard Pilgrim
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$54.95 / $83.18 / $123.03
Harvard Pilgrim
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$104.71 / $162.18 / $234.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.91 / $190.55 / $371.54
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$50.12 / $66.07 / $125.89
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$97.72 / $123.03 / $245.47