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Pregnancy Blood Screening For Birth Defects

Pennsylvania 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?

$69.18

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $69.18 for this service. The price depends on where it is billed: about $58.88 from a physician practice, and about $145 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 9 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$58.88$56.23 to $77.62
FacilityA hospital or hospital-owned outpatient department$145$83.18 to $209

How much rates vary

Facilitymedian $145 · 10th to 90th $59 to $537Professionalmedian $59 · 10th to 90th $54 to $347
$50$100$200$500facility $145professional $59

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
$58.88
Median
$144.54
Typical High
$724.44
Aetna
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$58.88
Typical High
$346.74
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$251.19
Median
$338.84
Typical High
$8,511.38
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$53.70
Typical High
$53.70
Cigna
Setting
Facility
Modifier
Global
Typical Low
$50.12
Median
$107.15
Typical High
$234.42
Cigna
Setting
Professional
Modifier
Global
Typical Low
$47.86
Median
$83.18
Typical High
$104.71
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$40.74
Typical High
$100.00
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$69.18
Typical High
$69.18
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$69.18
Typical High
$120.23
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$165.96
Median
$165.96
Typical High
$173.78
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$41.69
Median
$52.48
Typical High
$85.11
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$56.23
Median
$165.96
Typical High
$724.44
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$58.88
Typical High
$346.74
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$89.13
Median
$154.88
Typical High
$269.15
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$70.79
Typical High
$75.86
United
Setting
Facility
Modifier
Global
Typical Low
$34.67
Median
$69.18
Typical High
$83.18
United
Setting
Professional
Modifier
Global
Typical Low
$29.51
Median
$41.69
Typical High
$104.71

Where Pennsylvania 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.

Pennsylvania· 29th of 51

$69.18

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.