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Pennsylvania 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
$36.31 / $77.62 / $138.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.72 / $181.97 / $549.54
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$36.31 / $69.18 / $218.78
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$56.23 / $89.13 / $346.74
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.86 / $89.13 / $134.90
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$33.88 / $46.77 / $75.86
Ambetter
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$46.77 / $60.26 / $102.33
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.20 / $141.25 / $204.17
Capital Blue Cross
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$42.66 / $54.95 / $102.33
Capital Blue Cross
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$69.18 / $87.10 / $125.89
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$9.77 / $45.71 / $66.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $125.89 / $213.80
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$32.36 / $50.12 / $81.28
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$47.86 / $77.62 / $131.83
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.83 / $154.88 / $186.21
Emblem Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$34.67 / $54.95 / $66.07
Emblem Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$61.66 / $97.72 / $123.03
Geisinger
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $125.89 / $208.93
Geisinger
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$35.48 / $52.48 / $83.18
Geisinger
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$38.90 / $74.13 / $128.82
Highmark BCBS
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$457.09 / $457.09 / $512.86
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $128.82 / $181.97
Highmark BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$43.65 / $47.86 / $66.07
Highmark BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$64.57 / $91.20 / $107.15
Independence Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $162.18 / $204.17
Independence Blue Cross
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$50.12 / $56.23 / $81.28
Martin's Point
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$36.31 / $72.44 / $138.04
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.50 / $162.18 / $389.05
Martin's Point
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$36.31 / $60.26 / $151.36
Martin's Point
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$56.23 / $87.10 / $173.78
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $169.82 / $234.42
UPMC Health Plan
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$39.81 / $47.86 / $47.86
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.88 / $74.13 / $147.91
UPMC Health Plan
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$39.81 / $41.69 / $47.86
UPMC Health Plan
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$60.26 / $64.57 / $72.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.62 / $114.82 / $181.97
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$33.11 / $44.67 / $72.44
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$51.29 / $72.44 / $117.49