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South Dakota rates for HCPCS 76857

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

Facilitymedian $24 · 10th–90th $24$240%50%100%$24Professionalmedian $50 · 10th–90th $22$1260%5%10%10th90th$50$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$23.99 / $23.99 / $23.99
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $87.10 / $158.49
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$21.88 / $35.48 / $85.11
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$22.91 / $64.57 / $112.20
Avera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $87.10 / $91.20
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $120.23 / $147.91
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$43.65 / $54.95 / $69.18
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$51.29 / $64.57 / $81.28
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $95.50 / $575.44
Medica
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$24.55 / $50.12 / $234.42
Medica
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$23.99 / $46.77 / $398.11
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $109.65 / $109.65
Midlands
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$50.12 / $57.54 / $57.54
Midlands
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$51.29 / $51.29 / $57.54
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $83.18 / $134.90
Sanford Health Plan
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$24.55 / $38.90 / $45.71
Sanford Health Plan
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$28.84 / $44.67 / $109.65
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $87.10 / $134.90
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$20.89 / $32.36 / $53.70
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$28.18 / $42.66 / $75.86
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $104.71 / $104.71
Wellmark
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$41.69 / $48.98 / $48.98
Wellmark
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$47.86 / $56.23 / $56.23