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Hawaii rates for HCPCS 76857

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

Facilitymedian $27 · 10th–90th $23$320%10%20%10th90th$27Professionalmedian $48 · 10th–90th $21$1350%5%10th90th$48$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
$23.44 / $26.92 / $31.62
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $70.79 / $194.98
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$18.20 / $32.36 / $77.62
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$19.95 / $33.88 / $74.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $70.79 / $151.36
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$18.62 / $26.30 / $52.48
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$19.95 / $39.81 / $109.65
HMSA
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $128.82 / $141.25
HMSA
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$30.20 / $30.90 / $32.36
HMSA
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$97.72 / $97.72 / $102.33
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $66.07 / $77.62
Kaiser Permanente
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$26.30 / $28.84 / $33.88
Kaiser Permanente
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$33.88 / $37.15 / $43.65
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $79.43 / $125.89
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$23.44 / $37.15 / $190.55
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$23.99 / $39.81 / $102.33
University Health Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $89.13 / $162.18
University Health Alliance
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$20.89 / $33.88 / $52.48
University Health Alliance
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$35.48 / $60.26 / $125.89