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New Hampshire rates for HCPCS 76857

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

Facilitymedian $26 · 10th–90th $19$710%20%10th90th$26Professionalmedian $49 · 10th–90th $22$1120%5%10th90th$49$5.0$20.0$100.0$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
$19.05 / $33.11 / $70.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $70.79 / $181.97
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$18.20 / $32.36 / $58.88
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$18.20 / $33.11 / $70.79
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.92 / $41.69 / $173.78
Ambetter
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$28.84 / $30.20 / $77.62
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $56.23 / $91.20
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$23.44 / $25.12 / $40.74
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$27.54 / $28.18 / $48.98
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $100.00 / $204.17
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$23.44 / $34.67 / $63.10
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$30.90 / $52.48 / $154.88
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $83.18 / $134.90
Harvard Pilgrim
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$28.18 / $39.81 / $66.07
Harvard Pilgrim
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$32.36 / $48.98 / $77.62
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $91.20 / $158.49
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$25.70 / $33.11 / $77.62
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$30.20 / $45.71 / $93.33
Well Sense
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$16.22 / $20.42 / $22.39