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Limited Pregnancy Ultrasound

New Hampshire rates for HCPCS 76815

A quick, focused ultrasound during pregnancy used to check on a specific concern rather than perform a full evaluation, such as confirming the baby's heartbeat, position, or the amount of amniotic fluid. It is shorter and narrower in scope than a complete pregnancy ultrasound and is often used for a follow-up look between full exams. It does not replace a full anatomy scan.

Rates data updated October 2026.

How much does Limited Pregnancy Ultrasound cost?

$117

Typical negotiated rate. In New Hampshire, October 2026.

Insurers have agreed to pay about $117 for this service. The price depends on where it is billed: about $117 from a physician practice, and about $407 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$117$102 to $166
FacilityA hospital or hospital-owned outpatient department$407$158 to $501

How much rates vary

Facilitymedian $407 · 10th to 90th $93 to $513Professionalmedian $117 · 10th to 90th $89 to $224
$100$200$500facility $407professional $117

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$93.33
Median
$93.33
Typical High
$158.49
Aetna
Setting
Professional
Modifier
None (both parts)
Typical Low
$83.18
Median
$93.33
Typical High
$208.93
Aetna
Setting
Professional
Modifier
26 · Professional part
Typical Low
$29.51
Median
$31.62
Typical High
$77.62
Aetna
Setting
Professional
Modifier
TC · Technical part
Typical Low
$51.29
Median
$61.66
Typical High
$131.83
Ambetter
Setting
Professional
Modifier
None (both parts)
Typical Low
$67.61
Median
$199.53
Typical High
$234.42
Ambetter
Setting
Professional
Modifier
26 · Professional part
Typical Low
$24.55
Median
$39.81
Typical High
$74.13
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$363.08
Median
$501.19
Typical High
$512.86
Anthem BCBS
Setting
Professional
Modifier
None (both parts)
Typical Low
$81.28
Median
$117.49
Typical High
$204.17
Anthem BCBS
Setting
Professional
Modifier
26 · Professional part
Typical Low
$30.90
Median
$44.67
Typical High
$63.10
Anthem BCBS
Setting
Professional
Modifier
TC · Technical part
Typical Low
$51.29
Median
$72.44
Typical High
$117.49
Cigna
Setting
Facility
Modifier
None
Typical Low
$275.42
Median
$426.58
Typical High
$645.65
Cigna
Setting
Professional
Modifier
None (both parts)
Typical Low
$102.33
Median
$117.49
Typical High
$245.47
Cigna
Setting
Professional
Modifier
26 · Professional part
Typical Low
$38.02
Median
$43.65
Typical High
$91.20
Cigna
Setting
Professional
Modifier
TC · Technical part
Typical Low
$67.61
Median
$74.13
Typical High
$151.36
Harvard Pilgrim
Setting
Professional
Modifier
None (both parts)
Typical Low
$89.13
Median
$125.89
Typical High
$263.03
Harvard Pilgrim
Setting
Professional
Modifier
26 · Professional part
Typical Low
$33.88
Median
$46.77
Typical High
$89.13
Harvard Pilgrim
Setting
Professional
Modifier
TC · Technical part
Typical Low
$56.23
Median
$79.43
Typical High
$144.54
United
Setting
Professional
Modifier
None (both parts)
Typical Low
$91.20
Median
$112.20
Typical High
$223.87
United
Setting
Professional
Modifier
26 · Professional part
Typical Low
$33.88
Median
$40.74
Typical High
$85.11
United
Setting
Professional
Modifier
TC · Technical part
Typical Low
$58.88
Median
$70.79
Typical High
$138.04
3 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$33.11
Median
$46.77
Typical High
$47.86
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$13.18
Median
$18.62
Typical High
$19.05
Aetna
Setting
Professional
Modifier
FX · Film X-ray
Typical Low
$53.70
Median
$74.13
Typical High
$74.13

Where New Hampshire sits

The same service costs 3.6 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

New Hampshire· 15th of 51

$117

AK $245TX $67.61

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.