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Arizona rates for HCPCS 76816

Ultrasound, pregnant uterus, real time with image documentation, follow-up (eg, re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ system(s) suspected or confirmed to be abnormal on a previous scan), transabdominal approach, per fetus

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$46.11 / $116.25 / $172.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.44 / $177.86 / $513.00
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$36.61 / $53.09 / $211.20
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$56.82 / $70.43 / $168.15
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.00 / $82.46 / $128.84
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$30.55 / $30.76 / $53.83
Ambetter
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$48.46 / $48.46 / $94.39
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.70 / $105.04 / $139.04
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$23.96 / $31.94 / $39.93
BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$46.07 / $61.42 / $76.78
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$46.25 / $46.25 / $46.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.07 / $126.73 / $217.59
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$34.13 / $48.47 / $79.48
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$57.94 / $77.87 / $139.87
Medica
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$181.68 / $181.68 / $181.68
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$105.27 / $118.03 / $708.49
Medica
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$40.65 / $44.61 / $257.68
Medica
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$68.52 / $73.56 / $450.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.71 / $115.13 / $197.79
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$40.65 / $44.40 / $70.91
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$68.52 / $72.22 / $113.99