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Pennsylvania 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
$42.66 / $85.11 / $162.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.03 / $229.09 / $616.60
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$42.66 / $81.28 / $181.97
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$72.44 / $117.49 / $251.19
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $112.20 / $194.98
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$38.02 / $51.29 / $79.43
Ambetter
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$56.23 / $69.18 / $128.82
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.82 / $169.82 / $288.40
Capital Blue Cross
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$46.77 / $63.10 / $117.49
Capital Blue Cross
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$83.18 / $109.65 / $173.78
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$11.48 / $53.70 / $77.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.65 / $165.96 / $263.03
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$38.02 / $58.88 / $93.33
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$70.79 / $107.15 / $169.82
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.18 / $190.55 / $229.09
Emblem Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$40.74 / $63.10 / $77.62
Emblem Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$79.43 / $123.03 / $154.88
Geisinger
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.65 / $165.96 / $281.84
Geisinger
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$40.74 / $60.26 / $95.50
Geisinger
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$64.57 / $102.33 / $177.83
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.54 / $158.49 / $234.42
Highmark BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$51.29 / $54.95 / $77.62
Highmark BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$89.13 / $117.49 / $134.90
Martin's Point
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$42.66 / $72.44 / $162.18
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.23 / $199.53 / $407.38
Martin's Point
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$41.69 / $67.61 / $151.36
Martin's Point
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$75.86 / $114.82 / $218.78
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.72 / $229.09 / $302.00
UPMC Health Plan
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$46.77 / $53.70 / $53.70
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.88 / $97.72 / $338.84
UPMC Health Plan
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$45.71 / $47.86 / $53.70
UPMC Health Plan
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$83.18 / $85.11 / $93.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.65 / $141.25 / $229.09
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$38.90 / $51.29 / $83.18
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$70.79 / $93.33 / $151.36