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)

Medicare pricing summary

Low

Average

$141

Median

$107

High

$1.9k

Medicare rate distribution

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284 hospital rates

#		Plans
1	Boston Medical Center Boston, MA other · both	1	$121	$121	—	—	117	$121 – $121
2	DELTA COUNTY MEMORIAL HOSPITAL DELTA, CO other · outpatient	1	$110	$110	—	—	89	$110 – $110
3	John Muir Health Walnut Creek, CA other · both	3	$148	$148	—	—	80	$148 – $148
4	CATHOLIC HEALTH INITIATIVES COLORADO Colorado Springs, CO other · inpatient	1	$93	$93	—	—	38	$93 – $93
5	John Muir Health Concord, CA other · both	3	$148	$148	—	—	30	$148 – $148
6	STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER JACKSON, MS other · outpatient	1	$94	$94	—	—	28	$94 – $94
7	Martha's Vineyard Hospital Bluffs, MA percent of total billed charges · outpatientfrom % of charges	1	$414	$414	—	—	24	$414 – $414
8	Massachusetts General Hospital Boston, MA other · both	1	$126	$126	—	—	24	$126 – $126
9	CATHOLIC HEALTH INITIATIVES COLORADO Durango, CO other · inpatient	1	$90	$90	—	—	22	$90 – $90
10	Mercy Hospital Springfield Ozark, MO facility · other · outpatient	1	$103	$103	—	—	22	$103 – $103
11	Mercy Hospital Springfield Springfield, MO facility · other · outpatient	1	$103	$103	—	—	22	$103 – $103
12	St Peters Hospital Albany, NY professional · percent of total billed charges · outpatientfrom % of charges	1	$110	$110	$59	53%	22–31	$51 – $168
13	Benefis Hospitals Inc Helena, MT other · outpatient	1	$107	$107	—	—	21	$107 – $107
14	Brigham and Women's Hospital Boston, MA other · both	1	$126	$126	—	—	20	$126 – $126
15	Lowell General Hospital Lowell, MA other · both	1	$485	$485	$36	7%	19	$449 – $520
16	Mercy Hospital Rogers dba Mercy Hospital Northwest Arkansas Rogers, AR facility · other · outpatient	1	$96	$96	—	—	18	$96 – $96
17	CATHOLIC HEALTH INIATIVES COLORADO Westminster, CO other · inpatient	1	$72	$72	—	—	16	$72 – $72
18	Mercy Hospital Oklahoma City Inc City, OK facility · other · outpatient	1	$97	$97	—	—	16	$97 – $97
19	PRISMA HEALTH GREER MEMORIAL HOSPITAL GREER, SC other · both	1	$100	$100	—	—	16	$100 – $100
20	CATHOLIC HEALTH INITIATIVES COLORADO Pueblo, CO other · inpatient	1	$100	$100	—	—	15	$100 – $100
21	LONGMONT UNITED HOSPITAL Longmont, CO other · inpatient	1	$78	$78	—	—	15	$78 – $78
22	PRISMA HEALTH BAPTIST PARKRIDGE HOSPITAL COLUMBIA, SC other · both	1	$100	$100	—	—	15	$100 – $100
23	PRISMA HEALTH RICHLAND HOSPITAL COLUMBIA, SC other · both	1	$100	$100	—	—	15	$100 – $100
24	MELROSEWAKEFIELD HEALTHCARE Medford, MA other · both	1	$439	$439	$82	19%	14	$357 – $520
25	PRISMA HEALTH HILLCREST HOSPITAL SIMPSONVILLE, SC other · both	1	$100	$100	—	—	12	$100 – $100

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CPT 76857