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Ohio rates for HCPCS 76857

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

Facilitymedian $28 · 10th–90th $22$440%20%10th90th$28Professionalmedian $48 · 10th–90th $22$1350%10%10th90th$48$0.2$1.0$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
$22.39 / $27.54 / $43.65
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $79.43 / $263.03
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$19.95 / $36.31 / $69.18
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$19.05 / $32.36 / $100.00
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$35.48 / $43.65 / $67.61
Ambetter
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$17.78 / $22.91 / $40.74
Ambetter
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$10.00 / $10.47 / $20.89
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $83.18 / $128.82
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$19.05 / $25.70 / $40.74
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$40.74 / $56.23 / $87.10
Aultcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $58.88 / $97.72
Aultcare
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$26.30 / $28.18 / $46.77
Aultcare
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$27.54 / $30.90 / $50.12
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $33.88 / $63.10
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $70.79 / $144.54
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$18.62 / $27.54 / $46.77
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$20.42 / $38.90 / $109.65
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $70.79 / $151.36
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$19.50 / $30.20 / $54.95
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$20.42 / $37.15 / $109.65
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.78 / $32.36 / $33.11
SummaCare
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$128.82 / $128.82 / $128.82
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $52.48 / $89.13
SummaCare
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$22.91 / $28.84 / $51.29
SummaCare
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$13.18 / $19.95 / $54.95
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $58.88 / $109.65
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$17.38 / $25.12 / $58.88
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$19.50 / $27.54 / $79.43