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Limited Retroperitoneal Ultrasound

South Dakota 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 $29 · 10th–90th $29$290%50%100%$29Professionalmedian $63 · 10th–90th $26$1410%10%20%10th90th$63$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
$28.84
Median
$28.84
Typical High
$28.84
Aetna
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$85.11
Typical High
$141.25
Aetna
Setting
Professional
Modifier
26 · Professional part
Typical Low
$25.12
Median
$27.54
Typical High
$117.49
Aetna
Setting
Professional
Modifier
TC · Technical part
Typical Low
$32.36
Median
$85.11
Typical High
$162.18
Avera
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$104.71
Typical High
$109.65
Cigna
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$144.54
Typical High
$181.97
Cigna
Setting
Professional
Modifier
26 · Professional part
Typical Low
$51.29
Median
$64.57
Typical High
$81.28
Cigna
Setting
Professional
Modifier
TC · Technical part
Typical Low
$64.57
Median
$79.43
Typical High
$100.00
Medica
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$109.65
Typical High
$562.34
Medica
Setting
Professional
Modifier
26 · Professional part
Typical Low
$29.51
Median
$56.23
Typical High
$186.21
Medica
Setting
Professional
Modifier
TC · Technical part
Typical Low
$30.20
Median
$60.26
Typical High
$398.11
Midlands
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$131.83
Typical High
$131.83
Midlands
Setting
Professional
Modifier
26 · Professional part
Typical Low
$58.88
Median
$67.61
Typical High
$67.61
Midlands
Setting
Professional
Modifier
TC · Technical part
Typical Low
$64.57
Median
$64.57
Typical High
$70.79
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$100.00
Typical High
$141.25
Sanford Health Plan
Setting
Professional
Modifier
26 · Professional part
Typical Low
$34.67
Median
$44.67
Typical High
$52.48
Sanford Health Plan
Setting
Professional
Modifier
TC · Technical part
Typical Low
$35.48
Median
$56.23
Typical High
$104.71
United
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$104.71
Typical High
$165.96
United
Setting
Professional
Modifier
26 · Professional part
Typical Low
$29.51
Median
$38.02
Typical High
$61.66
United
Setting
Professional
Modifier
TC · Technical part
Typical Low
$34.67
Median
$53.70
Typical High
$85.11
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$125.89
Typical High
$128.82
Wellmark
Setting
Professional
Modifier
26 · Professional part
Typical Low
$47.86
Median
$56.23
Typical High
$57.54
Wellmark
Setting
Professional
Modifier
TC · Technical part
Typical Low
$60.26
Median
$70.79
Typical High
$70.79