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Utah rates for HCPCS 76817

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

Facilitymedian $275 · 10th–90th $40$2750%50%10th$275Professionalmedian $100 · 10th–90th $45$3800%5%10th90th$100$20.0$50.0$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$39.81 / $275.42 / $275.42
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $158.49 / $446.68
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$33.88 / $70.79 / $151.36
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$50.12 / $66.07 / $147.91
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $128.82 / $194.98
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$38.02 / $48.98 / $75.86
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$54.95 / $75.86 / $117.49
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $85.11
Regence BlueShield
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$199.53 / $199.53 / $199.53
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $169.82 / $204.17
Regence BlueShield
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$50.12 / $66.07 / $81.28
Regence BlueShield
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$81.28 / $102.33 / $123.03
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $141.25 / $204.17
Select Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$34.67 / $56.23 / $83.18
Select Health
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$53.70 / $85.11 / $117.49
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $79.43 / $151.36
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $100.00 / $165.96
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$35.48 / $38.90 / $64.57
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$56.23 / $61.66 / $109.65