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Limited Retroperitoneal Ultrasound

Maine 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 $33 · 10th–90th $32$3,8020%50%10th90th$33Professionalmedian $63 · 10th–90th $28$1450%5%10%10th90th$63$20.0$100.0$500.0$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
26 · Professional part
Typical Low
$31.62
Median
$33.11
Typical High
$3,801.89
Aetna
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$87.10
Typical High
$204.17
Aetna
Setting
Professional
Modifier
26 · Professional part
Typical Low
$21.88
Median
$33.11
Typical High
$69.18
Aetna
Setting
Professional
Modifier
TC · Technical part
Typical Low
$22.91
Median
$33.88
Typical High
$85.11
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$87.10
Typical High
$117.49
Anthem BCBS
Setting
Professional
Modifier
26 · Professional part
Typical Low
$26.92
Median
$38.90
Typical High
$51.29
Anthem BCBS
Setting
Professional
Modifier
TC · Technical part
Typical Low
$31.62
Median
$46.77
Typical High
$61.66
Cigna
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$97.72
Typical High
$181.97
Cigna
Setting
Professional
Modifier
26 · Professional part
Typical Low
$26.92
Median
$40.74
Typical High
$66.07
Cigna
Setting
Professional
Modifier
TC · Technical part
Typical Low
$36.31
Median
$63.10
Typical High
$114.82
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$91.20
Typical High
$173.78
Harvard Pilgrim
Setting
Professional
Modifier
26 · Professional part
Typical Low
$31.62
Median
$42.66
Typical High
$77.62
Harvard Pilgrim
Setting
Professional
Modifier
TC · Technical part
Typical Low
$37.15
Median
$54.95
Typical High
$95.50
Martin's Point
Setting
Facility
Modifier
26 · Professional part
Typical Low
$31.62
Median
$33.11
Typical High
$3,801.89
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$87.10
Typical High
$144.54
Martin's Point
Setting
Professional
Modifier
26 · Professional part
Typical Low
$25.12
Median
$33.88
Typical High
$69.18
Martin's Point
Setting
Professional
Modifier
TC · Technical part
Typical Low
$33.88
Median
$46.77
Typical High
$85.11
United
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$95.50
Typical High
$158.49
United
Setting
Professional
Modifier
26 · Professional part
Typical Low
$28.18
Median
$43.65
Typical High
$114.82
United
Setting
Professional
Modifier
TC · Technical part
Typical Low
$30.20
Median
$47.86
Typical High
$95.50