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Payers and negotiated rates for CPT 76857-26 | medprice.ai

CPT 76857-26

US EXAM PELVIC LIMITED

Payer pricing summary

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Low

$14

Average

$24

Median

$23

High

$38

Payer rate distribution

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Filter by billing methodology

All methodologies Case rate 0 Fee schedule 7 Per diem 0 Percent of billed charges 6 Other 0

Filter by billing class

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#
1	Humana fee schedule · both · +2 other terms	2	$23	$23	$1	3%	—	$22 – $24
2	UnitedHealthcare fee schedule · both	2	$26	$24	$3	14%	—	$22 – $30
3	Aetna fee schedule · both · +1 other terms	1	$22	$22	—	—	—	$22 – $22
4	Amerihealth Caritas facility · percent of total billed charges · outpatientfrom % of charges	1	$14	$14	$0	1%	—	$13 – $14
5	Cigna fee schedule · both · +1 other terms	1	$22	$22	—	—	—	$22 – $22
6	Highmark facility · percent of total billed charges · outpatientfrom % of charges	1	$28	$28	$9	31%	—	$13 – $36
7	MultiPlan facility · percent of total billed charges · inpatientfrom % of charges · +1 other terms	1	$38	$38	—	—	—	$38 – $38
8	Optum fee schedule · both	1	$22	$22	—	—	—	$22 – $22
9	Tricare fee schedule · both	1	$22	$22	—	—	—	$22 – $22
10	WellCare fee schedule · both	1	$22	$22	—	—	—	$22 – $22

← Hospitals reporting CPT 76857-26 · Snapshot 20261113T090226Z-3ce6c0b8