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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)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$96.95 / $291.10 / $291.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$133.50 / $170.36 / $917.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$198.60 / $265.22 / $402.04
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.49 / $97.97 / $190.84
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$285.04 / $358.94 / $425.21
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$202.46 / $210.17 / $334.06