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Limited Retroperitoneal Ultrasound

Alaska rates for HCPCS 76775

A focused ultrasound exam of the structures behind the abdominal cavity, such as the kidneys or major blood vessels, that looks at a specific area or concern rather than fully evaluating the whole region. It's often used as a follow-up to check on a previously identified finding. It's a narrower exam than a complete retroperitoneal ultrasound.

Rates data updated July 2026.

Facilitymedian $93 · 10th–90th $89$1170%20%40%10th90th$93Professionalmedian $95 · 10th–90th $30$2340%5%10th90th$95$10.0$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. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
26 · Professional part
Typical Low
$89.13
Median
$93.33
Typical High
$117.49
Aetna
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$100.00
Typical High
$251.19
Aetna
Setting
Professional
Modifier
26 · Professional part
Typical Low
$26.30
Median
$33.88
Typical High
$97.72
Aetna
Setting
Professional
Modifier
TC · Technical part
Typical Low
$29.51
Median
$61.66
Typical High
$117.49
Cigna
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$117.49
Typical High
$218.78
Cigna
Setting
Professional
Modifier
26 · Professional part
Typical Low
$23.44
Median
$46.77
Typical High
$95.50
Cigna
Setting
Professional
Modifier
TC · Technical part
Typical Low
$34.67
Median
$64.57
Typical High
$123.03
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$181.97
Typical High
$316.23
Moda Health
Setting
Professional
Modifier
26 · Professional part
Typical Low
$67.61
Median
$89.13
Typical High
$138.04
Moda Health
Setting
Professional
Modifier
TC · Technical part
Typical Low
$77.62
Median
$97.72
Typical High
$151.36
Premera BCBS
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$245.47
Typical High
$371.54
Premera BCBS
Setting
Professional
Modifier
26 · Professional part
Typical Low
$102.33
Median
$114.82
Typical High
$162.18
Premera BCBS
Setting
Professional
Modifier
TC · Technical part
Typical Low
$107.15
Median
$131.83
Typical High
$181.97
Providence
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$109.65
Typical High
$186.21
Providence
Setting
Professional
Modifier
26 · Professional part
Typical Low
$23.44
Median
$33.88
Typical High
$102.33
Providence
Setting
Professional
Modifier
TC · Technical part
Typical Low
$29.51
Median
$44.67
Typical High
$131.83
United
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$151.36
Typical High
$316.23
United
Setting
Professional
Modifier
26 · Professional part
Typical Low
$30.20
Median
$95.50
Typical High
$173.78
United
Setting
Professional
Modifier
TC · Technical part
Typical Low
$44.67
Median
$91.20
Typical High
$162.18