Limited pelvic ultrasound exam at Holy Name

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

EXAM:US PELVIS,LIMITED STUDY

Teaneck, NJ

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Pricing by billing methodology

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How this price compares nationally

Holy Name’s median price of $572 is 256% above the median hospital's median price ($161), higher than 92% of the 2,596 hospitals reporting CPT 76857. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 76857 at Holy Name

Negotiated rates from the hospital’s own file: 9 payers, 21 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.

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#
1	Aetna whole health facility · fee schedule · outpatient	$108	$108	—	—	—	$108 – $108
2	Aetna medicare prime facility · fee schedule · outpatient	$113	$113	—	—	—	$113 – $113
3	Aetna golden medicare facility · fee schedule · outpatient	$125	$125	—	—	—	$125 – $125
4	Clover clover facility · fee schedule · outpatient	$125	$125	—	—	—	$125 – $125
5	UnitedHealthcare medicare facility · fee schedule · outpatient	$125	$125	—	—	—	$125 – $125
6	WellCare medicare facility · fee schedule · outpatient	$126	$126	—	—	—	$126 – $126
7	UnitedHealthcare medicaid facility · percent of total billed charges · outpatientfrom % of charges	$168	$168	—	—	—	$168 – $168
8	Aetna better health mcd/chip facility · percent of total billed charges · outpatientfrom % of charges	$176	$176	—	—	—	$176 – $176
9	Aetna qualified health plans facility · percent of total billed charges · outpatientfrom % of charges	$202	$202	—	—	—	$202 – $202
10	Ambetter ambetter facility · percent of total billed charges · outpatientfrom % of charges	$263	$263	—	—	—	$263 – $263
11	Aetna hmo/pos facility · percent of total billed charges · outpatientfrom % of charges	$355	$355	—	—	—	$355 – $355
12	Cigna hmo/pos facility · fee schedule · outpatient	$364	$364	—	—	—	$364 – $364
13	First Health first health facility · percent of total billed charges · outpatientfrom % of charges	$503	$503	—	—	—	$503 – $503
14	Aetna worker's comp facility · percent of total billed charges · outpatientfrom % of charges	$642	$642	—	—	—	$642 – $642
15	MultiPlan multiplan facility · percent of total billed charges · outpatientfrom % of charges	$684	$684	—	—	—	$684 – $684
16	MultiPlan worker's comp facility · percent of total billed charges · outpatientfrom % of charges	$894	$894	—	—	—	$894 – $894
17	UnitedHealthcare uhc facility · other · outpatient	$895	$895	—	—	—	$895 – $895
18	MultiPlan auto accident medical facility · percent of total billed charges · outpatientfrom % of charges	$947	$947	—	—	—	$947 – $947
19	Blue Cross Blue Shield indemnity facility · percent of total billed charges · outpatientfrom % of charges	$975	$975	—	—	—	$975 – $975
20	Blue Cross Blue Shield managed facility · percent of total billed charges · outpatientfrom % of charges	$975	$975	—	—	—	$975 – $975
21	Blue Cross Blue Shield ppo facility · percent of total billed charges · outpatientfrom % of charges	$975	$975	—	—	—	$975 – $975

Last updated: Nov 10, 2025

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