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Tennessee rates for HCPCS 76831

Saline infusion sonohysterography (SIS), including color flow Doppler, when performed

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$29.76 / $29.76 / $187.22
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.88 / $126.37 / $304.39
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$80.87 / $149.61 / $198.22
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$88.94 / $151.35 / $236.27
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$39.29 / $39.29 / $39.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.61 / $133.68 / $229.34
Lucent Health
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$81.20 / $168.77 / $168.77
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$756.60 / $756.60 / $954.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.09 / $133.07 / $220.18