Limited ultrasound of the abdominal back wall

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

PR US Retroperitoneal Limited|PROFESSIONAL COMPONENT

Payers reporting CPT 76775

Payer pricing summary

Low

$42

Average

$632

Median

$265

High

$9.0k

Payer rate distribution

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#
1	Bcbs Al facility · other · outpatient · +5 other terms	6	$157	$156	$28	18%	423–522	$120 – $191
2	Medicare other · both · +22 other terms	44	$110	$135	$86	64%	378–540	$71 – $617
3	Aetna fee schedule · outpatient · +41 other terms	727	$132	$243	$327	134%	167–599	$1 – $8.4k
4	Anthem fee schedule · outpatient · +37 other terms	199	$166	$152	$165	109%	98–278	$2 – $1.7k
5	Blue Cross Blue Shield fee schedule · outpatient · +39 other terms	535	$189	$217	$191	88%	97–160	$1 – $3.1k
6	Bcbs Mt fee schedule · outpatient · +2 other terms	1	$179	$179	$65	36%	65–74	$114 – $244
7	UnitedHealthcare fee schedule · outpatient · +43 other terms	787	$179	$196	$250	127%	39–282	$1 – $7.3k
8	Molina fee schedule · outpatient · +35 other terms	266	$103	$101	$56	55%	38–110	$1 – $557
9	Humana fee schedule · outpatient · +35 other terms	441	$111	$152	$225	148%	22–220	$1 – $5.2k
10	Bcbs In other · both · +1 other terms	11	$381	$383	$70	18%	12–120	$254 – $507
11	Cigna fee schedule · outpatient · +39 other terms	520	$183	$269	$292	108%	11–110	$22 – $4.4k
12	First Health fee schedule · outpatient · +21 other terms	66	$212	$351	$491	140%	2–20	$33 – $2.4k
13	Kaiser fee schedule · outpatient · +26 other terms	109	$151	$215	$250	116%	1–10	$28 – $2.1k
14	Caresource fee schedule · outpatient · +24 other terms	82	$108	$111	$52	47%	1–10	$1 – $399
15	Highmark facility · fee schedule · outpatient · +23 other terms	75	$150	$166	$130	78%	1–10	$21 – $651
16	Optum fee schedule · outpatient · +26 other terms	62	$98	$275	$459	167%	1–10	$30 – $2.1k
17	Premera facility · fee schedule · both · +20 other terms	25	$107	$138	$101	73%	1–10	$31 – $388
18	Medical Mutual facility · fee schedule · outpatient · +21 other terms	18	$99	$371	$1.2k	323%	1–10	$35 – $6.0k
19	WellCare fee schedule · outpatient · +29 other terms	196	$113	$116	$41	36%	—	$22 – $304
20	MultiPlan fee schedule · outpatient · +25 other terms	138	$643	$523	$524	100%	—	$36 – $2.7k
21	Ambetter fee schedule · outpatient · +25 other terms	111	$181	$147	$103	70%	—	$20 – $817
22	Devoted facility · fee schedule · outpatient · +20 other terms	104	$106	$135	$316	234%	—	$14 – $4.9k
23	Aetna Better Health fee schedule · outpatient · +20 other terms	91	$65	$83	$52	63%	—	$20 – $385
24	Tricare facility · fee schedule · outpatient · +22 other terms	88	$105	$152	$316	208%	—	$13 – $4.6k
25	Oscar facility · fee schedule · outpatient · +23 other terms	71	$153	$142	$56	40%	—	$42 – $351

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