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Nebraska rates for HCPCS 76857

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$22.69 / $73.09 / $203.12
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.99 / $93.13 / $321.32
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$18.01 / $52.84 / $81.95
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$23.30 / $49.48 / $107.56
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.45 / $83.69 / $93.65
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$22.69 / $32.57 / $52.90
Ambetter
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$47.06 / $48.71 / $48.71
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.10 / $90.98 / $94.20
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$40.82 / $44.07 / $45.38
BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$42.93 / $47.34 / $49.02
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$130.08 / $130.08 / $130.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.41 / $106.74 / $155.00
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$18.94 / $51.43 / $66.90
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$20.78 / $51.85 / $90.58
Medica
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$115.00 / $115.00 / $115.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.33 / $93.09 / $181.31
Medica
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$23.38 / $42.14 / $232.81
Medica
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$28.27 / $49.40 / $398.91
Midlands
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$60.58 / $62.35 / $130.08
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.11 / $107.00 / $164.17
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.77 / $46.13 / $94.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.08 / $96.58 / $114.75
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$25.29 / $45.27 / $58.71
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$26.10 / $44.31 / $87.32