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Missouri rates for HCPCS 76857

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

Facilitymedian $31 · 10th–90th $23$540%20%10th90th$31Professionalmedian $46 · 10th–90th $21$1510%5%10th90th$46$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
$22.91 / $30.90 / $53.70
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $79.43 / $309.03
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$19.05 / $35.48 / $87.10
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$18.20 / $30.90 / $112.20
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $36.31 / $83.18
Ambetter
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$17.38 / $18.20 / $34.67
Ambetter
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$17.78 / $17.78 / $19.95
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $56.23 / $123.03
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$24.55 / $28.84 / $43.65
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$20.89 / $26.30 / $87.10
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $56.23 / $74.13
BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$24.55 / $26.30 / $33.88
BCBS
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$26.92 / $29.51 / $44.67
Cigna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$5.75 / $26.92 / $38.02
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $72.44 / $154.88
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$17.78 / $26.92 / $61.66
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$20.89 / $39.81 / $117.49
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
$45.71 / $79.43 / $575.44
Medica
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$19.95 / $30.90 / $234.42
Medica
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$21.88 / $40.74 / $398.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $61.66 / $117.49
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$19.50 / $27.54 / $83.18
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$21.88 / $28.84 / $83.18