Obstetric ultrasound, single fetus, 14 weeks or more

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

facility

Tricare pricing summary

Low

$31

Average

$159

Median

$105

High

$1.5k

Tricare rate distribution

Filter by billing methodology

Filter by billing class

419 hospital rates

#		Plans
1	Benefis Hospitals Inc Helena, MT other · outpatient	1	$106	$106	—	—	80	$106 – $106
2	Mercy Hospital Springfield Ozark, MO facility · other · outpatient	1	$103	$103	—	—	40	$103 – $103
3	Mercy Hospital Springfield Springfield, MO facility · other · outpatient	1	$103	$103	—	—	40	$103 – $103
4	Mercy Hospital Lebanon dba Mercy Hospital Lebanon Rolla, MO facility · other · outpatient	1	$110	$110	—	—	15	$110 – $110
5	Columbia Lutheran Charities Astoria, OR facility · percent of total billed charges · bothfrom % of charges	1	$312	$312	—	—	13	$312 – $312
6	STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER JACKSON, MS other · outpatient	1	$94	$94	—	—	13	$94 – $94
7	Eisenhower Medical Center Rancho Mirage, CA other · both	3	$134	$134	—	—	4–40	$134 – $134
8	OKTIBBEHA COUNTY HOSPITAL STARKVILLE, MS other · outpatient	1	$90	$90	—	—	3–30	$90 – $90
9	Mercy Perry Perryville, MO facility · percent of total billed charges · outpatientfrom % of charges	1	$209	$209	$103	50%	2–20	$105 – $312
10	Trios Health Kennewick, WA fee schedule · both	3	$110	$110	—	—	2–20	$110 – $110
11	Brigham and Women's Hospital Boston, MA other · both	1	$120	$120	—	—	1–10	$120 – $120
12	Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · fee schedule · outpatient	1	$82	$82	$38	47%	1–10	$44 – $121
13	Lowell General Hospital Lowell, MA other · both	1	$520	$520	—	—	1–10	$520 – $520
14	PRISMA HEALTH BAPTIST COLUMBIA HOSPITAL COLUMBIA, SC other · both	1	$98	$98	—	—	1–10	$98 – $98
15	PRISMA HEALTH BAPTIST PARKRIDGE HOSPITAL COLUMBIA, SC other · both	1	$100	$100	—	—	1–10	$100 – $100
16	PRISMA HEALTH BLOUNT MEMORIAL HOSPITAL MARYVILLE, TN other · both	1	$99	$99	—	—	1–10	$99 – $99
17	PRISMA HEALTH GREER MEMORIAL HOSPITAL GREER, SC other · both	1	$99	$99	—	—	1–10	$99 – $99
18	PRISMA HEALTH RICHLAND HOSPITAL COLUMBIA, SC other · both	1	$100	$100	—	—	1–10	$100 – $100
19	PRISMA HEALTH TUOMEY HOSPITAL SUMTER, SC other · both	1	$100	$100	—	—	1–10	$100 – $100
20	STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER GRENADA, MS other · outpatient	1	$90	$90	—	—	1–10	$90 – $90
21	The Mercy Hospital Inc Springfield, MA professional · fee schedule · outpatient	1	$88	$88	$43	49%	1–10	$45 – $131
22	ACADIA GENERAL HOSPITAL, INC 1305 CROWLEY RAYNE HWY other · outpatient	1	$97	$97	—	—	—	$97 – $97
23	ALBANY MEDICAL CENTER HOSPITAL Albany, NY professional · fee schedule · outpatient	4	$62	$74	$36	48%	—	$38 – $125
24	Affinity Hospital LLC Birmingham, AL facility · fee schedule · outpatient	1	$91	$91	—	—	—	$91 – $91
25	AnMed Health Anderson, SC professional · fee schedule · inpatient	1	$104	$95	$34	36%	—	$45 – $126

Page 1 of 17

← Payers reporting CPT 76805 · Snapshot 20261111T120946Z-9134e7f7

CPT 76805