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Missouri 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
$38.89 / $48.10 / $75.59
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.75 / $162.22 / $576.00
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$35.40 / $62.76 / $223.00
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$57.28 / $70.04 / $186.23
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.43 / $86.75 / $136.94
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$29.84 / $44.76 / $64.03
Ambetter
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$52.44 / $94.39 / $110.51
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$105.03 / $127.50 / $206.33
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$43.09 / $50.56 / $80.20
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$61.94 / $75.16 / $120.81
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
$82.47 / $133.74 / $240.11
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$34.65 / $53.52 / $98.63
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$51.11 / $81.56 / $150.97
Medica
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$95.69 / $181.68 / $181.68
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.62 / $138.51 / $708.49
Medica
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$40.77 / $53.72 / $257.68
Medica
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$62.73 / $85.58 / $450.80
Qualchoice
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$69.09 / $69.09 / $73.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.62 / $122.94 / $230.26
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$38.97 / $48.66 / $81.70
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$60.47 / $75.43 / $130.32