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Limited Retroperitoneal Ultrasound

New Hampshire 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?

$87.10

Typical negotiated rate. In New Hampshire, October 2026.

Insurers have agreed to pay about $87.10 for this service. The price depends on where it is billed: about $87.10 from a physician practice, and about $269 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 6 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$87.10$66.07 to $115
FacilityA hospital or hospital-owned outpatient department$269$115 to $380

How much rates vary

Facilitymedian $269 · 10th to 90th $115 to $513Professionalmedian $87 · 10th to 90th $49 to $162
$50$100$200$500facility $269professional $87

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

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$114.82
Median
$114.82
Typical High
$114.82
Aetna
Setting
Professional
Modifier
None (both parts)
Typical Low
$51.29
Median
$114.82
Typical High
$141.25
Aetna
Setting
Professional
Modifier
26 · Professional part
Typical Low
$24.55
Median
$28.84
Typical High
$53.70
Aetna
Setting
Professional
Modifier
TC · Technical part
Typical Low
$26.30
Median
$85.11
Typical High
$85.11
Ambetter
Setting
Professional
Modifier
None (both parts)
Typical Low
$50.12
Median
$64.57
Typical High
$64.57
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$269.15
Median
$371.54
Typical High
$380.19
Anthem BCBS
Setting
Professional
Modifier
None (both parts)
Typical Low
$48.98
Median
$87.10
Typical High
$123.03
Anthem BCBS
Setting
Professional
Modifier
26 · Professional part
Typical Low
$26.92
Median
$38.90
Typical High
$54.95
Anthem BCBS
Setting
Professional
Modifier
TC · Technical part
Typical Low
$33.88
Median
$40.74
Typical High
$83.18
Cigna
Setting
Facility
Modifier
None
Typical Low
$151.36
Median
$275.42
Typical High
$645.65
Cigna
Setting
Professional
Modifier
None (both parts)
Typical Low
$77.62
Median
$89.13
Typical High
$194.98
Cigna
Setting
Professional
Modifier
26 · Professional part
Typical Low
$33.11
Median
$38.90
Typical High
$79.43
Cigna
Setting
Professional
Modifier
TC · Technical part
Typical Low
$44.67
Median
$50.12
Typical High
$120.23
Harvard Pilgrim
Setting
Professional
Modifier
None (both parts)
Typical Low
$66.07
Median
$95.50
Typical High
$194.98
Harvard Pilgrim
Setting
Professional
Modifier
26 · Professional part
Typical Low
$29.51
Median
$41.69
Typical High
$77.62
Harvard Pilgrim
Setting
Professional
Modifier
TC · Technical part
Typical Low
$37.15
Median
$57.54
Typical High
$100.00
United
Setting
Professional
Modifier
None (both parts)
Typical Low
$67.61
Median
$83.18
Typical High
$151.36
United
Setting
Professional
Modifier
26 · Professional part
Typical Low
$30.20
Median
$36.31
Typical High
$74.13
United
Setting
Professional
Modifier
TC · Technical part
Typical Low
$36.31
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
$22.39
Median
$56.23
Typical High
$56.23
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$8.91
Median
$22.91
Typical High
$22.91
Aetna
Setting
Professional
Modifier
FX · Film X-ray
Typical Low
$35.48
Median
$91.20
Typical High
$91.20

Where New Hampshire 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.

New Hampshire· 22nd of 51

$87.10

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.