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Arizona rates for HCPCS 76812

Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; each additional gestation (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$119.27 / $288.52 / $360.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$133.50 / $196.23 / $861.00
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$135.02 / $225.03 / $318.14
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$121.12 / $161.50 / $201.87
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$96.73 / $96.73 / $96.73
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$161.21 / $221.59 / $390.99
Medica
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$200.27 / $379.97 / $379.97
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.20 / $210.17 / $1,243.70
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.20 / $204.29 / $337.79