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Limited Retroperitoneal Ultrasound

Missouri 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 October 2026.

How much does Limited Retroperitoneal Ultrasound cost?

$97.72

Typical negotiated rate. In Missouri, October 2026.

Insurers have agreed to pay about $97.72 for this service. The price depends on where it is billed: about $97.72 from a physician practice, and about $138 from a hospital or other facility.

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.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$97.72$58.88 to $129
FacilityA hospital or hospital-owned outpatient department$138$102 to $257

How much rates vary

Facilitymedian $138 · 10th to 90th $65 to $468Professionalmedian $98 · 10th to 90th $49 to $562
$50$100$200$500facility $138professional $98

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$51.29
Median
$70.79
Typical High
$154.88
Aetna
Setting
Professional
Modifier
None (both parts)
Typical Low
$51.29
Median
$57.54
Typical High
$120.23
Aetna
Setting
Professional
Modifier
26 · Professional part
Typical Low
$23.99
Median
$26.92
Typical High
$44.67
Aetna
Setting
Professional
Modifier
TC · Technical part
Typical Low
$27.54
Median
$30.90
Typical High
$85.11
Ambetter
Setting
Professional
Modifier
None (both parts)
Typical Low
$43.65
Median
$43.65
Typical High
$46.77
Ambetter
Setting
Professional
Modifier
26 · Professional part
Typical Low
$21.38
Median
$26.92
Typical High
$40.74
Anthem BCBS
Setting
Professional
Modifier
None (both parts)
Typical Low
$48.98
Median
$109.65
Typical High
$190.55
Anthem BCBS
Setting
Professional
Modifier
26 · Professional part
Typical Low
$28.18
Median
$44.67
Typical High
$57.54
Anthem BCBS
Setting
Professional
Modifier
TC · Technical part
Typical Low
$25.70
Median
$61.66
Typical High
$107.15
BCBS Kansas City
Setting
Facility
Modifier
None
Typical Low
$61.66
Median
$85.11
Typical High
$151.36
BCBS Kansas City
Setting
Professional
Modifier
None (both parts)
Typical Low
$63.10
Median
$66.07
Typical High
$87.10
BCBS Kansas City
Setting
Professional
Modifier
26 · Professional part
Typical Low
$29.51
Median
$30.20
Typical High
$39.81
BCBS Kansas City
Setting
Professional
Modifier
TC · Technical part
Typical Low
$33.11
Median
$36.31
Typical High
$47.86
Cigna
Setting
Facility
Modifier
None
Typical Low
$102.33
Median
$151.36
Typical High
$457.09
Cigna
Setting
Professional
Modifier
None (both parts)
Typical Low
$43.65
Median
$64.57
Typical High
$147.91
Cigna
Setting
Professional
Modifier
26 · Professional part
Typical Low
$19.95
Median
$26.92
Typical High
$51.29
Cigna
Setting
Professional
Modifier
TC · Technical part
Typical Low
$23.44
Median
$32.36
Typical High
$104.71
Medica
Setting
Facility
Modifier
None
Typical Low
$64.57
Median
$151.36
Typical High
$512.86
Medica
Setting
Professional
Modifier
None (both parts)
Typical Low
$61.66
Median
$562.34
Typical High
$562.34
Medica
Setting
Professional
Modifier
26 · Professional part
Typical Low
$27.54
Median
$186.21
Typical High
$186.21
Medica
Setting
Professional
Modifier
TC · Technical part
Typical Low
$30.90
Median
$398.11
Typical High
$398.11
Qualchoice
Setting
Professional
Modifier
None (both parts)
Typical Low
$91.20
Median
$91.20
Typical High
$91.20
United
Setting
Facility
Modifier
None
Typical Low
$331.13
Median
$331.13
Typical High
$346.74
United
Setting
Professional
Modifier
None (both parts)
Typical Low
$58.88
Median
$81.28
Typical High
$125.89
United
Setting
Professional
Modifier
26 · Professional part
Typical Low
$26.30
Median
$31.62
Typical High
$53.70
United
Setting
Professional
Modifier
TC · Technical part
Typical Low
$29.51
Median
$42.66
Typical High
$83.18
3 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$25.70
Median
$28.18
Typical High
$31.62
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$10.23
Median
$11.48
Typical High
$12.59
Aetna
Setting
Professional
Modifier
FX · Film X-ray
Typical Low
$40.74
Median
$45.71
Typical High
$50.12

Where Missouri sits

The same service costs 3.8 times more in Alaska than in Texas. 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.

Missouri· 14th of 51

$97.72

AK $182TX $47.86

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.