go back

Alaska rates for HCPCS 76817

Ultrasound, pregnant uterus, real time with image documentation, transvaginal

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$114.82 / $131.83 / $154.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.86 / $120.23 / $407.38
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$28.84 / $47.86 / $141.25
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$45.71 / $69.18 / $158.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $181.97 / $295.12
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$39.81 / $70.79 / $123.03
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$43.65 / $100.00 / $165.96
Moda Health
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$114.82 / $123.03 / $154.88
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.82 / $269.15 / $407.38
Moda Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$52.48 / $109.65 / $177.83
Moda Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$85.11 / $154.88 / $229.09
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.74 / $398.11 / $602.56
Premera BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$134.90 / $151.36 / $234.42
Premera BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$208.93 / $239.88 / $363.08
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.20 / $169.82 / $288.40
Providence
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$34.67 / $51.29 / $131.83
Providence
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$54.95 / $77.62 / $177.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $295.12 / $501.19
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$38.02 / $131.83 / $223.87
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$63.10 / $169.82 / $281.84