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.
Original text from hospital filings
Limited US Pelvic (Non-OB)
Low
$1
Average
$314
Median
$212
High
$10.6k
Each hospital's average Blue Cross Blue Shield rate, under the methodology and billing class chosen below.
1441 hospitals; the 90th percentile is 6.1× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
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2,401 hospital rates
iThe hospitals that file a Blue Cross Blue Shield rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | The Carle Foundation Hospital Urbana, IL percent of total billed charges · outpatientfrom % of charges | 2 | $891 | $884 | $26 | 3% | 802 | $846 – $908 |
| 2 | Brigham and Women's Hospital Boston, MA other · outpatient | 2 | $232 | $232 | — | — | 569 | $232 – $232 |
| 3 | Mayo Clinic Rochester, MN professional · percent of total billed charges · outpatientfrom % of charges | 7 | $300 | $262 | $72 | 27% | 304 | $135 – $323 |
| 4 | Self Regional Healthcare Greenwood, SC facility · other · outpatient | 2 | $164 | $164 | $60 | 37% | 251–260 | $104 – $224 |
| 5 | North Carolina Baptist Hospital Winston Salem, NC percent of total billed charges · outpatientfrom % of charges | 4 | $109 | $104 | $18 | 18% | 228 | $75 – $122 |
| 6 | North Carolina Baptist Hospital Bermuda Run, NC percent of total billed charges · outpatientfrom % of charges | 4 | $350 | $332 | $58 | 18% | 228 | $239 – $391 |
| 7 | Covenant Medical Center Inc Saginaw, MI professional · other · both | 1 | $53 | $53 | — | — | 222 | $53 – $53 |
| 8 | PRISMA HEALTH BAPTIST EASLEY HOSPITAL EASLEY, SC fee schedule · both | 4 | $146 | $180 | $92 | 51% | 112–121 | $94 – $334 |
| 9 | PRISMA HEALTH GREENVILLE MEMORIAL HOSPITAL GREENVILLE, SC fee schedule · both | 4 | $146 | $180 | $92 | 51% | 112–121 | $94 – $334 |
| 10 | Newton Wellesley Hospital Newton, MA other · outpatient | 2 | $199 | $199 | — | — | 102 | $199 – $199 |
| 11 | Methodist Medical Center of Illinois Peoria, IL percent of total billed charges · outpatientfrom % of charges | 4 | $369 | $365 | $11 | 3% | 84 | $342 – $378 |
| 12 | PRISMA HEALTH BAPTIST PARKRIDGE HOSPITAL COLUMBIA, SC fee schedule · both | 3 | $224 | $235 | $120 | 51% | 81–90 | $94 – $388 |
| 13 | PRISMA HEALTH RICHLAND HOSPITAL COLUMBIA, SC fee schedule · both | 3 | $224 | $235 | $120 | 51% | 81–90 | $94 – $388 |
| 14 | Mercy Hospital Rogers dba Mercy Hospital Northwest Arkansas Rogers, AR facility · fee schedule · outpatient | 2 | $103 | $103 | — | — | 80 | $103 – $103 |
| 15 | Boston Medical Center Boston, MA fee schedule · both | 1 | $129 | $129 | — | — | 73 | $129 – $129 |
| 16 | Lowell General Hospital Lowell, MA fee schedule · both | 2 | $161 | $161 | — | — | 41 | $161 – $161 |
| 17 | Mayo Clinic Health System Mankato 56001-4752 facility · percent of total billed charges · bothfrom % of charges | 6 | $218 | $221 | $10 | 4% | 41–59 | $207 – $237 |
| 18 | Mercy Health Saint Marys Rockford, MI facility · fee schedule · both | 1 | $43 | $43 | — | — | 41–122 | $43 – $43 |
| 19 | Allina Health Systems Buffalo, MN facility · other · outpatient | 5 | $333 | $344 | $125 | 36% | 35–116 | $128 – $493 |
| 20 | Allina Health Systems Shakopee, MN facility · other · outpatient | 5 | $333 | $344 | $125 | 36% | 34–115 | $128 – $493 |
| 21 | Allina Health Systems Owatonna, MN facility · other · outpatient | 5 | $333 | $344 | $125 | 36% | 34–115 | $128 – $493 |
| 22 | Allina Health Systems Cambridge, MN facility · other · outpatient | 5 | $333 | $344 | $125 | 36% | 34–115 | $128 – $493 |
| 23 | Allina Health Systems Faribualt, MN facility · other · outpatient | 5 | $333 | $344 | $125 | 36% | 34–115 | $128 – $493 |
| 24 | Bexar County Hospital District San Antonio, TX percent of total billed charges · outpatientfrom % of charges | 2 | $190 | $190 | $9 | 5% | 32–68 | $181 – $199 |
| 25 | FHN Memorial Hospital Freeport, IL percent of total billed charges · outpatientfrom % of charges | 1 | $334 | $501 | $243 | 49% | 32 | $324 – $844 |
← Payers reporting CPT 76857 · Snapshot 20261111T120946Z-9134e7f7