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Alaska rates for HCPCS 76857

Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles)

Facilitymedian $85 · 10th–90th $76$3310%20%10th90th$85Professionalmedian $50 · 10th–90th $20$1510%5%10th90th$50$5.0$10.0$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
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$75.86 / $85.11 / $331.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $61.66 / $204.17
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$18.20 / $28.84 / $70.79
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$16.98 / $30.20 / $91.20
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $102.33 / $181.97
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$20.89 / $39.81 / $81.28
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$28.18 / $53.70 / $104.71
Moda Health
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$74.13 / $85.11 / $331.13
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $138.04 / $229.09
Moda Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$23.99 / $69.18 / $120.23
Moda Health
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$31.62 / $72.44 / $112.20
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $204.17 / $309.03
Premera BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$89.13 / $100.00 / $141.25
Premera BCBS
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$87.10 / $107.15 / $147.91
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $100.00 / $151.36
Providence
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$21.38 / $33.11 / $70.79
Providence
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$23.44 / $41.69 / $104.71
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $134.90 / $263.03
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$20.42 / $69.18 / $147.91
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$36.31 / $81.28 / $114.82