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Utah 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)

Facilitymedian $295 · 10th–90th $95–$2950%50%10th$295Professionalmedian $200 · 10th–90th $135–$4470%10%10th90th$200$50.0$100.0$200.0$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$95.50 / $295.12 / $295.12
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $199.53 / $467.74
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $263.03 / $398.11
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $173.78
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $354.81 / $426.58
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $295.12 / $426.58
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $162.18 / $309.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $204.17 / $338.84