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New York rates for HCPCS 76857

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

Facilitymedian $27 · 10th–90th $19$620%20%10th90th$27Professionalmedian $49 · 10th–90th $21$1700%5%10th90th$49$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
$19.05 / $26.92 / $61.66
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $83.18 / $323.59
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$19.05 / $33.88 / $81.28
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$18.20 / $33.88 / $93.33
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.99 / $37.15 / $46.77
Ambetter
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$17.78 / $18.62 / $36.31
Ambetter
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$10.47 / $20.89 / $30.90
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $50.12 / $147.91
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$18.62 / $22.91 / $43.65
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$21.38 / $26.30 / $77.62
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $33.88 / $67.61
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
$42.66 / $91.20 / $263.03
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$17.78 / $31.62 / $72.44
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$21.38 / $43.65 / $154.88
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $69.18 / $109.65
Emblem Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$23.99 / $35.48 / $79.43
Emblem Health
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$28.84 / $38.02 / $60.26
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $72.44 / $112.20
Excellus BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$15.14 / $31.62 / $58.88
Excellus BCBS
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$24.55 / $41.69 / $61.66
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $53.70 / $93.33
Highmark BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$26.92 / $27.54 / $50.12
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $67.61 / $109.65
MVP Health Care
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$28.18 / $33.88 / $53.70
MVP Health Care
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$27.54 / $32.36 / $57.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $74.13 / $223.87
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$19.05 / $30.90 / $147.91
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$21.88 / $38.02 / $204.17
Univera
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$19.05 / $27.54 / $60.26
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $67.61 / $128.82
Univera
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$17.38 / $30.90 / $67.61
Univera
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$23.99 / $38.90 / $75.86