Limited pelvic ultrasound exam

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

Limited US Pelvic (Non-OB)

Payers reporting CPT 76857

Payer pricing summary

Low

$36

Average

$589

Median

$231

High

$8.8k

Payer rate distribution

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#
1	Medicare other · both · +23 other terms	52	$111	$141	$88	63%	449–836	$97 – $520
2	Bcbs Al facility · other · outpatient · +5 other terms	6	$153	$160	$16	10%	146–254	$146 – $191
3	Anthem fee schedule · outpatient · +37 other terms	197	$156	$133	$146	110%	117–342	$2 – $1.4k
4	Molina fee schedule · outpatient · +35 other terms	269	$100	$94	$59	62%	60–105	$1 – $557
5	Aetna fee schedule · outpatient · +41 other terms	724	$117	$212	$302	143%	48–381	$1 – $8.4k
6	UnitedHealthcare fee schedule · outpatient · +44 other terms	798	$175	$178	$167	94%	23–230	$1 – $3.1k
7	Cigna fee schedule · outpatient · +37 other terms	516	$153	$243	$199	82%	12–120	$19 – $2.0k
8	Humana fee schedule · outpatient · +35 other terms	455	$108	$122	$111	90%	12–120	$0 – $1.3k
9	Blue Cross Blue Shield fee schedule · outpatient · +38 other terms	534	$174	$209	$183	88%	10–100	$1 – $2.7k
10	Bcbs In other · both · +1 other terms	11	$381	$394	$62	16%	4–40	$254 – $507
11	Ucare professional · fee schedule · outpatient · +22 other terms	23	$36	$35	$14	40%	3–30	$11 – $70
12	First Health fee schedule · outpatient · +21 other terms	68	$221	$273	$338	124%	2–20	$29 – $1.7k
13	Florida Blue fee schedule · outpatient · +2 other terms	1	$193	$193	$47	25%	2–20	$145 – $275
14	WellCare fee schedule · outpatient · +29 other terms	209	$111	$103	$50	49%	1–10	$19 – $341
15	Caresource fee schedule · outpatient · +24 other terms	93	$106	$96	$55	57%	1–10	$1 – $624
16	Premera facility · fee schedule · both · +19 other terms	25	$107	$137	$111	81%	1–10	$24 – $412
17	Wellmark facility · fee schedule · both · +29 other terms	25	$107	$143	$123	86%	1–10	$24 – $629
18	Carefirst facility · fee schedule · both · +16 other terms	24	$107	$133	$111	83%	1–10	$24 – $412
19	MultiPlan fee schedule · outpatient · +25 other terms	136	$473	$434	$426	98%	—	$31 – $2.2k
20	Ambetter fee schedule · outpatient · +25 other terms	124	$162	$126	$88	70%	—	$9 – $547
21	Kaiser fee schedule · outpatient · +29 other terms	111	$152	$196	$206	105%	—	$23 – $1.6k
22	Devoted facility · fee schedule · outpatient · +20 other terms	103	$106	$129	$319	247%	—	$44 – $4.9k
23	Aetna Better Health fee schedule · outpatient · +23 other terms	91	$55	$73	$49	66%	—	$25 – $385
24	Tricare facility · fee schedule · outpatient · +23 other terms	85	$105	$141	$342	242%	—	$23 – $4.6k
25	Highmark facility · fee schedule · outpatient · +23 other terms	71	$137	$140	$104	74%	—	$18 – $482

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