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Texas 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
$26.92 / $28.84 / $33.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $169.82 / $457.09
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$32.36 / $61.66 / $208.93
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$47.86 / $69.18 / $158.49
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.13 / $104.71 / $147.91
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$31.62 / $39.81 / $74.13
Ambetter
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$46.77 / $63.10 / $91.20
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $83.18 / $112.20
Baylor Scott & White
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.50 / $123.03 / $190.55
Christus
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$38.02 / $75.86 / $75.86
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
$87.10 / $117.49 / $223.87
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$33.11 / $44.67 / $87.10
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$53.70 / $72.44 / $144.54
Lucent Health
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$257.04 / $257.04 / $257.04
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.49 / $707.95 / $912.01
Lucent Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$257.04 / $323.59 / $323.59
Lucent Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$446.68 / $575.44 / $575.44
Moda Health
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$26.92 / $33.11 / $50.12
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $144.54 / $331.13
Moda Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$31.62 / $52.48 / $144.54
Moda Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$51.29 / $79.43 / $151.36
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $37.15 / $97.72
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.66 / $107.15 / $257.04
Providence
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$9.77 / $45.71 / $66.07
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.13 / $114.82 / $234.42
Providence
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$33.11 / $42.66 / $79.43
Providence
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$53.70 / $69.18 / $134.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.33 / $117.49 / $181.97
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$34.67 / $44.67 / $69.18
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$58.88 / $72.44 / $112.20
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.15 / $112.20 / $131.83
Wellpoint
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$39.81 / $41.69 / $50.12
Wellpoint
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$67.61 / $70.79 / $83.18