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Wyoming rates for HCPCS 76857

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$22.54 / $22.54 / $22.97
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.65 / $58.56 / $92.84
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$16.92 / $22.47 / $115.55
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$18.00 / $30.02 / $74.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.00 / $205.00 / $205.00
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$60.00 / $98.00 / $98.00
BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$65.00 / $107.00 / $107.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.02 / $93.04 / $141.15
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$20.35 / $36.47 / $57.83
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$29.85 / $44.77 / $87.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.20 / $101.37 / $330.00
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$19.05 / $48.75 / $71.50
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$40.20 / $55.30 / $266.19