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Oklahoma rates for HCPCS 76857

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

Facilitymedian $30 · 10th–90th $18$1150%20%10th90th$30Professionalmedian $37 · 10th–90th $19$850%5%10th90th$37$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
$18.20 / $29.51 / $128.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $53.70 / $134.90
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$18.20 / $30.20 / $64.57
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$16.98 / $26.92 / $70.79
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $50.12 / $83.18
Ambetter
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$18.20 / $18.20 / $30.90
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.44 / $44.67 / $61.66
Cigna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$17.78 / $17.78 / $27.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $75.86 / $109.65
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$16.22 / $21.38 / $33.11
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$20.42 / $56.23 / $85.11
Medica
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$56.23 / $114.82 / $114.82
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $66.07 / $575.44
Medica
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$19.95 / $26.30 / $234.42
Medica
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$20.42 / $37.15 / $398.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $52.48 / $107.15
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$19.50 / $24.55 / $44.67
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$19.50 / $25.12 / $87.10