go back

New Hampshire 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
$41.69 / $56.23 / $151.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.13 / $165.96 / $346.74
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$35.48 / $79.43 / $208.93
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$56.23 / $79.43 / $204.17
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.28 / $102.33 / $257.04
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$31.62 / $58.88 / $134.90
Ambetter
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$81.28 / $104.71 / $162.18
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.20 / $162.18 / $218.78
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$40.74 / $58.88 / $83.18
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$70.79 / $102.33 / $138.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $177.83 / $323.59
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$47.86 / $72.44 / $117.49
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$56.23 / $125.89 / $208.93
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.83 / $199.53 / $295.12
Harvard Pilgrim
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$47.86 / $69.18 / $107.15
Harvard Pilgrim
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$83.18 / $125.89 / $186.21
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.15 / $151.36 / $302.00
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$42.66 / $56.23 / $107.15
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$64.57 / $97.72 / $194.98