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Arizona rates for HCPCS 76857

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

Facilitymedian $81 · 10th–90th $27$1120%10%10th90th$81Professionalmedian $56 · 10th–90th $21$2240%5%10th90th$56$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$26.92 / $81.28 / $112.20
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $91.20 / $331.13
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$19.05 / $38.90 / $97.72
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$19.05 / $40.74 / $134.90
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $41.69 / $57.54
Ambetter
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$17.78 / $19.05 / $28.84
Ambetter
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$10.47 / $19.50 / $23.44
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $48.98 / $85.11
BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$18.62 / $20.89 / $37.15
BCBS
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$23.99 / $26.92 / $47.86
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $74.13 / $131.83
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$18.20 / $25.12 / $48.98
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$20.89 / $38.90 / $97.72
Medica
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$56.23 / $114.82 / $114.82
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $97.72 / $575.44
Medica
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$19.05 / $25.70 / $234.42
Medica
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$22.91 / $79.43 / $398.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $77.62 / $123.03
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$19.05 / $25.12 / $95.50
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$22.91 / $35.48 / $91.20