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
$176
Median
$110
High
$2.1k
Each hospital's average Molina rate, under the methodology and billing class chosen below.
837 hospitals; the 90th percentile is 7.1× 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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1,196 hospital rates
iThe hospitals that file a Molina 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 | STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER JACKSON, MS fee schedule · outpatient | 2 | $131 | $131 | $47 | 36% | 56–65 | $83 – $178 |
| 2 | Self Regional Healthcare Greenwood, SC facility · other · outpatient | 2 | $119 | $119 | $13 | 11% | 32 | $106 – $132 |
| 3 | Seattle Children's Hospital Seattle, WA professional · fee schedule · both | 2 | $29 | $29 | $14 | 51% | 24 | $14 – $43 |
| 4 | PRISMA HEALTH BAPTIST EASLEY HOSPITAL EASLEY, SC fee schedule · both | 1 | $96 | $96 | — | — | 22 | $96 – $96 |
| 5 | PRISMA HEALTH GREENVILLE MEMORIAL HOSPITAL GREENVILLE, SC fee schedule · both | 1 | $96 | $96 | — | — | 22 | $96 – $96 |
| 6 | PeaceHealth Southwest Medical Center Vancouver, WA facility · other · outpatient | 3 | $80 | $80 | $36 | 44% | 22–31 | $40 – $124 |
| 7 | The Carle Foundation Hospital Urbana, IL percent of total billed charges · outpatientfrom % of charges | 1 | $411 | $408 | $12 | 3% | 19 | $391 – $419 |
| 8 | Mercy Health Saint Marys Rockford, MI facility · other · both | 3 | $102 | $99 | $31 | 31% | 17–26 | $60 – $135 |
| 9 | St. Joseph Medical Center Bellingham, WA facility · other · outpatient | 2 | $130 | $99 | $39 | 39% | 15 | $51 – $130 |
| 10 | Seattle Children's Hospital Seattle, WA facility · percent of total billed charges · outpatientfrom % of charges | 2 | $454 | $454 | $222 | 49% | 12 | $232 – $676 |
| 11 | BAPTIST HEALTHCARE SYSTEM INC. Louisville, KY percent of total billed charges · outpatientfrom % of charges | 1 | $138 | $138 | — | — | 11 | $138 – $138 |
| 12 | Carle BroMenn Medical Center Normal, IL percent of total billed charges · outpatientfrom % of charges | 1 | $141 | $141 | — | — | 4–40 | $141 – $141 |
| 13 | Columbia Lutheran Charities Astoria, OR facility · percent of total billed charges · bothfrom % of charges | 2 | $77 | $74 | $20 | 27% | 4–40 | $39 – $96 |
| 14 | Methodist Medical Center of Illinois Peoria, IL percent of total billed charges · outpatientfrom % of charges | 1 | $191 | $189 | $3 | 2% | 3–30 | $185 – $191 |
| 15 | Proctor Community Hospital Peoria, IL percent of total billed charges · outpatientfrom % of charges | 1 | $287 | $284 | $5 | 2% | 3–30 | $277 – $287 |
| 16 | Central Washington Health Services Association Wenatchee, WA other · outpatient | 2 | $140 | $190 | $70 | 37% | 2–20 | $140 – $290 |
| 17 | Mercy Health Hackley Campus Muskogen, MI professional · fee schedule · both | 5 | $32 | $33 | $15 | 46% | 2–20 | $15 – $65 |
| 18 | ARH Tug Valley Health Services, Inc. Prestonsburg, KY percent of total billed charges · outpatientfrom % of charges | 1 | $197 | $197 | — | — | 1–10 | $197 – $197 |
| 19 | Adena Health System Chillicothe, OH facility · other · outpatient | 1 | $112 | $112 | — | — | 1–10 | $112 – $112 |
| 20 | Appalachian Regional Healthcare, Inc. Hazard, KY percent of total billed charges · outpatientfrom % of charges | 1 | $73 | $73 | — | — | 1–10 | $73 – $73 |
| 21 | BAPTIST HEALTHCARE SYSTEM INC Corbin, KY percent of total billed charges · outpatientfrom % of charges | 1 | $101 | $101 | — | — | 1–10 | $101 – $101 |
| 22 | BAPTIST HEALTHCARE SYSTEM INC Lexington, KY percent of total billed charges · outpatientfrom % of charges | 1 | $113 | $113 | — | — | 1–10 | $113 – $113 |
| 23 | BAPTIST HEALTHCARE SYSTEM INC Richmond, KY percent of total billed charges · outpatientfrom % of charges | 1 | $113 | $113 | — | — | 1–10 | $113 – $113 |
| 24 | BAPTIST HEALTHCARE SYSTEM INC Grange, KY percent of total billed charges · outpatientfrom % of charges | 1 | $113 | $113 | — | — | 1–10 | $113 – $113 |
| 25 | BAPTIST HEALTHCARE SYSTEM INC Paducah, KY percent of total billed charges · outpatientfrom % of charges | 1 | $101 | $101 | — | — | 1–10 | $101 – $101 |
← Payers reporting CPT 76857 · Snapshot 20261111T120946Z-9134e7f7