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Maryland rates for HCPCS 76815

Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$26.87 / $36.13 / $40.14
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.28 / $102.90 / $380.00
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$27.64 / $46.35 / $119.09
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$45.41 / $62.21 / $173.02
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.32 / $99.25 / $127.04
CareFirst
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$30.78 / $34.20 / $49.93
CareFirst
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$55.76 / $65.05 / $82.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.64 / $101.31 / $189.74
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$23.72 / $37.32 / $68.37
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$40.65 / $65.88 / $122.50
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.46 / $107.66 / $174.00
Kaiser Permanente
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$30.98 / $39.13 / $64.11
Kaiser Permanente
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$52.38 / $67.56 / $109.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.09 / $91.39 / $169.48
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$24.30 / $31.47 / $57.31
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$44.74 / $56.02 / $97.85
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.37 / $95.98 / $119.09
Wellpoint
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$26.21 / $35.74 / $45.17
Wellpoint
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$44.16 / $60.24 / $75.18