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Virginia 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
$35.86 / $65.38 / $143.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$96.83 / $104.65 / $216.50
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$35.85 / $39.42 / $81.23
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$58.46 / $68.79 / $128.22
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.21 / $125.81 / $177.86
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$36.07 / $45.91 / $64.67
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$63.13 / $79.27 / $113.18
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.61 / $123.67 / $293.92
CareFirst
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$46.18 / $46.18 / $87.28
CareFirst
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$66.43 / $71.19 / $134.55
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
$84.95 / $128.10 / $256.82
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$32.72 / $51.78 / $95.30
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$49.92 / $79.70 / $163.56
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.34 / $127.66 / $156.97
Kaiser Permanente
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$36.15 / $45.94 / $57.04
Kaiser Permanente
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$65.18 / $82.98 / $103.19
Medcost
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$54.89 / $72.00 / $124.61
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.00 / $105.09 / $183.00
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.72 / $125.64 / $258.94
Sentara
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$43.12 / $57.84 / $91.41
Sentara
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$70.06 / $92.74 / $160.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.76 / $121.75 / $194.51
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$32.13 / $50.51 / $71.03
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$43.21 / $70.17 / $124.87