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Montana 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
Professional
Modifier
Low / Median / High Price
$133.50 / $160.11 / $383.25
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.97 / $302.33 / $302.33
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$131.97 / $131.97 / $163.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.50 / $302.33 / $436.82
Providence
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$131.97 / $131.97 / $163.15
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$202.21 / $340.47 / $519.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$196.16 / $202.46 / $355.56