go back

Tennessee 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
$73.20 / $76.56 / $468.62
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$133.50 / $170.16 / $328.69
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$135.71 / $254.46 / $325.38
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$148.18 / $250.11 / $403.38
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
$156.19 / $220.93 / $386.18
Lucent Health
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$200.27 / $415.82 / $415.82
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,243.70 / $1,243.70 / $1,567.43
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.38 / $219.22 / $393.94