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Pregnancy Blood Screening For Birth Defects

Massachusetts rates for HCPCS 81512

Measures five substances in a pregnant woman's blood and combines those results with details such as her age and how far along the pregnancy is. The report gives the chance that the baby has a chromosome difference or an opening in the spine or skull. It is a risk estimate rather than a diagnosis.

Rates data updated July 2026.

How much does Pregnancy Blood Screening For Birth Defects cost?

$105

Typical negotiated rate. In Massachusetts, July 2026.

Insurers have agreed to pay about $105 for this service. The price depends on where it is billed: about $69.18 from a physician practice, and about $158 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 8 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$69.18$69.18 to $155
FacilityA hospital or hospital-owned outpatient department$158$112 to $204

How much rates vary

Facilitymedian $158 · 10th to 90th $69 to $331Professionalmedian $69 · 10th to 90th $62 to $347
$50$100$200$500$1K$2K$5Kfacility $158professional $69

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$158.49
Typical High
$346.74
Aetna
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$346.74
Typical High
$346.74
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$204.17
Typical High
$331.13
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$41.69
Median
$69.18
Typical High
$169.82
BCBS
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$141.25
Typical High
$204.17
Cigna
Setting
Facility
Modifier
Global
Typical Low
$45.71
Median
$93.33
Typical High
$134.90
Cigna
Setting
Professional
Modifier
Global
Typical Low
$41.69
Median
$85.11
Typical High
$181.97
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$83.18
Median
$4,897.79
Typical High
$9,772.37
Fallon Health
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$117.49
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$69.18
Typical High
$147.91
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$204.17
Typical High
$331.13
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$41.69
Median
$69.18
Typical High
$169.82
United
Setting
Facility
Modifier
Global
Typical Low
$38.02
Median
$69.18
Typical High
$83.18
United
Setting
Professional
Modifier
Global
Typical Low
$41.69
Median
$69.18
Typical High
$131.83

Where Massachusetts sits

The same service costs 6.6 times more in Vermont than in Washington, DC. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Massachusetts· 10th of 51

$105

VT $347DC $52.48

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.