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Washington rates for HCPCS 76857

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

Facilitymedian $38 · 10th–90th $25$850%20%10th90th$38Professionalmedian $59 · 10th–90th $22$2340%5%10th90th$59$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
$26.30 / $32.36 / $64.57
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $91.20 / $346.74
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$18.20 / $35.48 / $97.72
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$19.05 / $36.31 / $117.49
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.44 / $85.11 / $125.89
Ambetter
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$17.38 / $37.15 / $44.67
Ambetter
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$28.84 / $28.84 / $28.84
Asuris Northwest Health
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$213.80 / $213.80 / $213.80
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $100.00 / $151.36
Asuris Northwest Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$31.62 / $47.86 / $66.07
Asuris Northwest Health
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$34.67 / $52.48 / $79.43
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $109.65 / $190.55
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$20.89 / $37.15 / $69.18
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$30.90 / $64.57 / $138.04
Kaiser Permanente
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$21.88 / $44.67 / $229.09
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $109.65 / $154.88
Kaiser Permanente
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$21.38 / $38.90 / $60.26
Kaiser Permanente
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$32.36 / $60.26 / $117.49
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $33.11
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $39.81 / $147.91
Premera BCBS
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$30.90 / $30.90 / $31.62
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $104.71 / $144.54
Premera BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$31.62 / $48.98 / $67.61
Premera BCBS
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$36.31 / $57.54 / $85.11
Regence BlueShield
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$213.80 / $213.80 / $213.80
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $100.00 / $147.91
Regence BlueShield
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$31.62 / $46.77 / $66.07
Regence BlueShield
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$33.88 / $52.48 / $79.43
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $85.11 / $151.36
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$19.50 / $26.30 / $70.79
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$23.99 / $41.69 / $87.10
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $60.26 / $112.20
Wellpoint
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$25.70 / $27.54 / $48.98
Wellpoint
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$33.11 / $33.11 / $63.10