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Texas rates for HCPCS 76857

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

Facilitymedian $19 · 10th–90th $15$1480%10%20%10th90th$19Professionalmedian $41 · 10th–90th $18$1290%5%10th90th$41$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
$14.79 / $19.05 / $30.90
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $70.79 / $302.00
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$15.85 / $27.54 / $79.43
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$16.60 / $28.18 / $70.79
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$29.51 / $48.98 / $67.61
Ambetter
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$18.20 / $24.55 / $67.61
Ambetter
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$10.47 / $20.89 / $34.67
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.20 / $38.90 / $52.48
Baylor Scott & White
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $70.79 / $141.25
Christus
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$21.88 / $30.20 / $30.20
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
$39.81 / $74.13 / $151.36
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$16.60 / $23.99 / $45.71
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$19.50 / $38.02 / $112.20
Lucent Health
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$147.91 / $147.91 / $147.91
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $588.84 / $588.84
Lucent Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$239.88 / $239.88 / $239.88
Lucent Health
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$389.05 / $389.05 / $416.87
Moda Health
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$15.14 / $19.50 / $30.90
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$35.48 / $66.07 / $162.18
Moda Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$16.60 / $28.84 / $57.54
Moda Health
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$17.78 / $33.11 / $72.44
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.62 / $32.36 / $38.02
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$24.55 / $50.12 / $109.65
Providence
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$6.03 / $28.18 / $39.81
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $74.13 / $147.91
Providence
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$16.60 / $23.44 / $42.66
Providence
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$19.50 / $33.88 / $117.49
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $63.10 / $112.20
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$19.05 / $25.12 / $61.66
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$20.42 / $30.90 / $87.10
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $51.29 / $61.66
Wellpoint
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$22.91 / $23.99 / $28.84
Wellpoint
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$25.70 / $27.54 / $32.36