Early pregnancy ultrasound, single fetus at Samaritan Hospital

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

PR US Pregnant Uterus < 14 Weeks Single/1st Gestation

Troy, NY

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Pricing by billing methodology

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How this price compares nationally

Samaritan Hospital’s median price of $300 is 48% above the median hospital's median price ($203), higher than 66% of the 2,609 hospitals reporting CPT 76801. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 76801 at Samaritan Hospital

Negotiated rates from the hospital’s own file: 34 payers, 152 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.

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1	Humana tricare professional · fee schedule · both	$43	$43	—	—	1–10	$43 – $43
2	Tricare tricare professional · fee schedule · both	$43	$43	—	—	—	$43 – $43
3	Aetna aetna medicare advantage professional · fee schedule · both	$45	$45	—	—	—	$45 – $45
4	UnitedHealthcare united healthcare medicaid harp chip facility · fee schedule · both	$46	$46	—	—	—	$46 – $46
5	Anthem empire medicaid facility · fee schedule · both	$59	$59	—	—	—	$59 – $59
6	Excellus empire medicaid facility · fee schedule · both	$59	$59	—	—	—	$59 – $59
7	UnitedHealthcare uhc empire professional · fee schedule · both	$84	$84	—	—	55	$84 – $84
8	Aetna aetna professional · fee schedule · both	$87	$87	—	—	31	$87 – $87
9	Humana tricare professional · fee schedule · inpatient	$104	$104	—	—	—	$104 – $104
10	Humana tricare professional · fee schedule · outpatient	$104	$104	—	—	1–10	$104 – $104
11	Tricare tricare professional · fee schedule · inpatient	$104	$104	—	—	—	$104 – $104
12	Tricare tricare professional · fee schedule · outpatient	$104	$104	—	—	—	$104 – $104
13	Aetna aetna medicare advantage professional · fee schedule · inpatient	$112	$112	—	—	—	$112 – $112
14	Aetna aetna medicare advantage professional · fee schedule · outpatient	$112	$112	—	—	—	$112 – $112
15	Aetna pb xr 100% default professional · percent of total billed charges · bothfrom % of charges	$122	$122	—	—	—	$122 – $122
16	Ambetter pb xr 100% default professional · percent of total billed charges · bothfrom % of charges	$122	$122	—	—	—	$122 – $122
17	Amerihealth Caritas pb xr 100% default professional · percent of total billed charges · bothfrom % of charges	$122	$122	—	—	—	$122 – $122
18	Anthem pb xr 100% default professional · percent of total billed charges · bothfrom % of charges	$122	$122	—	—	70–151	$122 – $122
19	Blue Cross Blue Shield pb xr 100% default professional · percent of total billed charges · bothfrom % of charges	$122	$122	—	—	51–141	$122 – $122
20	Carefirst pb xr 100% default professional · percent of total billed charges · bothfrom % of charges	$122	$122	—	—	—	$122 – $122
21	Caresource pb xr 100% default professional · percent of total billed charges · bothfrom % of charges	$122	$122	—	—	—	$122 – $122
22	Cigna pb xr 100% default professional · percent of total billed charges · bothfrom % of charges	$122	$122	—	—	19	$122 – $122
23	Clover pb xr 100% default professional · percent of total billed charges · bothfrom % of charges	$122	$122	—	—	—	$122 – $122
24	Devoted pb xr 100% default professional · percent of total billed charges · bothfrom % of charges	$122	$122	—	—	—	$122 – $122
25	Excellus pb xr 100% default professional · percent of total billed charges · bothfrom % of charges	$122	$122	—	—	1–10	$122 – $122

Page 1 of 7 · 152 rates

Last updated: Mar 31, 2026

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