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Limited Retroperitoneal Ultrasound

Utah 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?

$48.98

Typical negotiated rate. In Utah, October 2026.

Insurers have agreed to pay about $48.98 for this service. The price depends on where it is billed: about $48.98 from a physician practice, and about $209 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 7 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$48.98$29.51 to $64.57
FacilityA hospital or hospital-owned outpatient department$209$120 to $275

How much rates vary

Facilitymedian $209 · 10th to 90th $120 to $447Professionalmedian $49 · 10th to 90th $26 to $100
$50$100$200$500$1Kfacility $209professional $49

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
$120.23
Median
$120.23
Typical High
$120.23
Aetna
Setting
Professional
Modifier
None (both parts)
Typical Low
$63.10
Median
$120.23
Typical High
$123.03
Aetna
Setting
Professional
Modifier
26 · Professional part
Typical Low
$26.30
Median
$32.36
Typical High
$45.71
Aetna
Setting
Professional
Modifier
TC · Technical part
Typical Low
$33.88
Median
$89.13
Typical High
$89.13
Cigna
Setting
Facility
Modifier
None
Typical Low
$114.82
Median
$190.55
Typical High
$891.25
Cigna
Setting
Professional
Modifier
None (both parts)
Typical Low
$69.18
Median
$109.65
Typical High
$123.03
Cigna
Setting
Professional
Modifier
26 · Professional part
Typical Low
$31.62
Median
$32.36
Typical High
$51.29
Cigna
Setting
Professional
Modifier
TC · Technical part
Typical Low
$37.15
Median
$77.62
Typical High
$77.62
Molina
Setting
Professional
Modifier
None (both parts)
Typical Low
$25.12
Median
$34.67
Typical High
$64.57
Regence BlueShield
Setting
Facility
Modifier
None
Typical Low
$173.78
Median
$229.09
Typical High
$457.09
Regence BlueShield
Setting
Professional
Modifier
None (both parts)
Typical Low
$85.11
Median
$91.20
Typical High
$107.15
Regence BlueShield
Setting
Professional
Modifier
26 · Professional part
Typical Low
$38.90
Median
$40.74
Typical High
$51.29
Regence BlueShield
Setting
Professional
Modifier
TC · Technical part
Typical Low
$46.77
Median
$50.12
Typical High
$56.23
Select Health
Setting
Facility
Modifier
None
Typical Low
$93.33
Median
$93.33
Typical High
$93.33
Select Health
Setting
Professional
Modifier
None (both parts)
Typical Low
$63.10
Median
$85.11
Typical High
$100.00
Select Health
Setting
Professional
Modifier
26 · Professional part
Typical Low
$29.51
Median
$38.90
Typical High
$45.71
Select Health
Setting
Professional
Modifier
TC · Technical part
Typical Low
$33.88
Median
$45.71
Typical High
$53.70
U of Utah Health Plan
Setting
Professional
Modifier
None
Typical Low
$27.54
Median
$53.70
Typical High
$125.89
United
Setting
Professional
Modifier
None (both parts)
Typical Low
$60.26
Median
$66.07
Typical High
$112.20
United
Setting
Professional
Modifier
26 · Professional part
Typical Low
$27.54
Median
$29.51
Typical High
$46.77
United
Setting
Professional
Modifier
TC · Technical part
Typical Low
$30.20
Median
$30.20
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
$29.51
Median
$60.26
Typical High
$60.26
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$11.75
Median
$23.99
Typical High
$23.99
Aetna
Setting
Professional
Modifier
FX · Film X-ray
Typical Low
$46.77
Median
$97.72
Typical High
$97.72

Where Utah 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.

Utah· 50th of 51

$48.98

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.