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Louisiana rates for HCPCS 76857

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

Facilitymedian $30 · 10th–90th $27–$400%20%40%10th90th$30Professionalmedian $39 · 10th–90th $19–$1120%5%10th90th$39$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 / $30.20 / $39.81
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $61.66 / $177.83
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$18.20 / $30.20 / $64.57
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$16.98 / $25.70 / $67.61
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$27.54 / $34.67 / $70.79
Ambetter
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$18.20 / $25.12 / $33.88
Ambetter
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$23.44 / $23.44 / $26.30
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $61.66 / $89.13
BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$25.70 / $30.90 / $38.90
BCBS
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$26.92 / $31.62 / $56.23
Christus
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$21.88 / $30.20 / $30.20
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $56.23 / $131.83
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$16.60 / $24.55 / $46.77
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$16.22 / $27.54 / $95.50
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $54.95 / $109.65
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$16.60 / $23.99 / $37.15
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$18.20 / $25.70 / $70.79