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Nebraska 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
$34.44 / $113.41 / $315.14
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.44 / $194.55 / $429.00
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$34.04 / $77.39 / $122.72
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$53.00 / $68.90 / $146.50
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$105.97 / $171.38 / $201.73
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$26.95 / $65.72 / $80.06
Ambetter
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$87.85 / $103.36 / $131.11
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$159.50 / $172.22 / $176.53
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$62.64 / $67.64 / $69.31
BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$96.87 / $104.59 / $107.20
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$199.56 / $199.56 / $199.56
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.59 / $200.39 / $268.58
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$32.88 / $79.09 / $101.81
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$55.05 / $121.31 / $166.78
Medica
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$84.08 / $163.00 / $163.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$113.05 / $171.50 / $274.14
Medica
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$43.86 / $68.73 / $105.92
Medica
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$64.30 / $104.48 / $372.64
Midlands
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$115.60 / $118.96 / $199.56
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$166.00 / $197.29 / $249.43
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.45 / $85.25 / $168.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.16 / $175.45 / $219.11
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$43.86 / $68.56 / $88.86
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$64.30 / $105.24 / $133.94