go back

Nebraska rates for HCPCS 76857

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

Facilitymedian $50 · 10th–90th $30$2140%10%20%10th90th$50Professionalmedian $54 · 10th–90th $22$1350%5%10th90th$54$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
$29.51 / $50.12 / $213.80
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $89.13 / $309.03
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$19.95 / $42.66 / $87.10
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$20.89 / $46.77 / $89.13
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $53.70 / $120.23
Ambetter
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$25.12 / $43.65 / $56.23
Ambetter
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$25.70 / $48.98 / $53.70
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $89.13 / $93.33
BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$40.74 / $43.65 / $46.77
BCBS
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$42.66 / $47.86 / $60.26
Cigna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$128.82 / $128.82 / $128.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $109.65 / $154.88
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$19.05 / $50.12 / $69.18
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$19.95 / $57.54 / $91.20
Medica
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$114.82 / $114.82 / $114.82
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $89.13 / $204.17
Medica
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$23.44 / $41.69 / $234.42
Medica
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$26.30 / $48.98 / $398.11
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $107.15 / $169.82
Midlands
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$45.71 / $51.29 / $79.43
Midlands
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$48.98 / $51.29 / $91.20
Midlands
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$128.82 / $128.82 / $128.82
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $112.20 / $154.88
Midlands
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$25.70 / $45.71 / $58.88
Midlands
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$58.88 / $81.28 / $117.49
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$24.55 / $47.86 / $104.71
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $91.20 / $147.91
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$23.44 / $36.31 / $58.88
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$26.30 / $46.77 / $93.33