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
US Pelvic Non OB Limited F/U
Ozark, MO
See all hospitals reporting CPT 76857 →Price type
Mercy Hospital Springfield’s median price of $136 is 16% below the median hospital's median price ($161), higher than 40% of the 2,651 hospitals reporting CPT 76857. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 16 payers, 39 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.
Filter by billing methodology
Filter by billing class
| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Aetna hb sprg ok medicaid facility · fee schedule · outpatient | $22 | $22 | — | — | — | $22 – $22 |
| 2 | Humana hb sprg ok medicaid facility · fee schedule · outpatient | $22 | $22 | — | — | — | $22 – $22 |
| 3 | Medicaid hb sprg ok medicaid facility · fee schedule · outpatient | $22 | $22 | — | — | — | $22 – $22 |
| 4 | Blue Cross Blue Shield hb sprg medicare facility · fee schedule · outpatient | $23 | $23 | — | — | — | $23 – $23 |
| 5 | Medicaid hb sprg/jopl ark medicaid facility · fee schedule · outpatient | $24 | $24 | — | — | — | $24 – $24 |
| 6 | Blue Cross Blue Shield hb sprg anthem pathways exchange facility · fee schedule · outpatient | $33 | $33 | — | — | — | $33 – $33 |
| 7 | Anthem hb sprg anthem alliance facility · fee schedule · outpatient | $36 | $36 | — | — | — | $36 – $36 |
| 8 | Blue Cross Blue Shield hb sprg anthem alliance facility · fee schedule · outpatient | $36 | $36 | — | — | — | $36 – $36 |
| 9 | Anthem hb sprg anthem blue access facility · fee schedule · outpatient | $55 | $55 | — | — | — | $55 – $55 |
| 10 | Blue Cross Blue Shield hb sprg anthem blue access facility · fee schedule · outpatient | $55 | $55 | — | — | — | $55 – $55 |
| 11 | Blue Cross Blue Shield hb sprg kancare healthy blue medicaid facility · fee schedule · outpatient | $60 | $60 | — | — | — | $60 – $60 |
| 12 | Medicaid hb sprg mo medicaid facility · fee schedule · outpatient | $91 | $91 | — | — | — | $91 – $91 |
| 13 | Ambetter hb sprg ambetter exchange mo facility · fee schedule · outpatient | $95 | $95 | — | — | — | $95 – $95 |
| 14 | Aetna hb sprg medicare facility · other · outpatient | $103 | $103 | — | — | 12 | $103 – $103 |
| 15 | Blue Cross Blue Shield hb sprg medicare facility · other · outpatient | $103 | $103 | — | — | 1–10 | $103 – $103 |
| 16 | Cigna hb sprg medicare facility · other · outpatient | $103 | $103 | — | — | — | $103 – $103 |
| 17 | Humana hb sprg humana medicare 100% facility · other · outpatient | $103 | $103 | — | — | 1–10 | $103 – $103 |
| 18 | Medica hb sprg medicare facility · other · outpatient | $103 | $103 | — | — | — | $103 – $103 |
| 19 | Medicare hb sprg medicare facility · other · outpatient | $103 | $103 | — | — | 22 | $103 – $103 |
| 20 | Tricare hb sprg tricare facility · other · outpatient | $103 | $103 | — | — | 1–10 | $103 – $103 |
| 21 | UnitedHealthcare hb sprg medicare facility · other · outpatient | $103 | $103 | — | — | — | $103 – $103 |
| 22 | UnitedHealthcare hb sprg uhc mcr 100% facility · other · outpatient | $103 | $103 | — | — | 13 | $103 – $103 |
| 23 | WellCare hb sprg & lebn wellcare mcr 103% facility · other · outpatient | $106 | $106 | — | — | — | $106 – $106 |
| 24 | Devoted hb sprg devoted health medicare advantage 104% w/seq facility · other · outpatient | $107 | $107 | — | — | 1–10 | $107 – $107 |
| 25 | Aetna hb sprg aetna commercial facility · fee schedule · outpatient | $117 | $117 | — | — | — | $117 – $117 |
Last updated: Jun 4, 2026
See Limited pelvic ultrasound exam pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.