go back

Vermont rates for HCPCS 76857

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

Facilitymedian $115 · 10th–90th $115$1150%50%100%$115Professionalmedian $38 · 10th–90th $18$1000%5%10%10th90th$38$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
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $56.23 / $123.03
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$18.20 / $25.70 / $50.12
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$16.98 / $30.20 / $70.79
BCBS
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$114.82 / $114.82 / $114.82
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $120.23 / $120.23
BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$28.18 / $58.88 / $58.88
BCBS
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$56.23 / $64.57 / $64.57
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $109.65 / $208.93
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$16.22 / $33.88 / $97.72
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$31.62 / $44.67 / $120.23
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $51.29 / $208.93
MVP Health Care
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$19.05 / $25.70 / $100.00
MVP Health Care
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$23.99 / $27.54 / $35.48
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $83.18 / $147.91
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$21.88 / $27.54 / $60.26
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$22.91 / $33.88 / $109.65