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 LTD/FOLLOW UP
Monroeville, PA
See all hospitals reporting CPT 76857 →Price type
UPMC East’s median price of $359 is 123% above the median hospital's median price ($161), higher than 79% 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: 6 payers, 40 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 | UnitedHealthcare unison kids facility · fee schedule · outpatient | $37 | $37 | — | — | — | $37 – $37 |
| 2 | Highmark medicaid facility · fee schedule · outpatient | $47 | $47 | — | — | — | $47 – $47 |
| 3 | Amerihealth Caritas community healthchoices (chc)/medicaid facility · fee schedule · outpatient | $50 | $50 | — | — | — | $50 – $50 |
| 4 | Highmark complete blue medicare advantage/freedom blue medicare advantage/security blue medicare advantage facility · fee schedule · outpatient | $70 | $70 | — | — | — | $70 – $70 |
| 5 | UnitedHealthcare unison advantage non special needs facility · fee schedule · outpatient | $106 | $106 | — | — | — | $106 – $106 |
| 6 | UnitedHealthcare medicare facility · fee schedule · outpatient | $108 | $108 | — | — | — | $108 – $108 |
| 7 | Aetna medicare facility · fee schedule · outpatient | $109 | $109 | $3 | 2% | — | $106 – $112 |
| 8 | Highmark medicare facility · fee schedule · outpatient | $109 | $109 | — | — | — | $109 – $109 |
| 9 | Amerihealth Caritas medicare facility · fee schedule · outpatient | $109 | $109 | — | — | — | $109 – $109 |
| 10 | Cigna medicare facility · fee schedule · outpatient | $109 | $109 | — | — | — | $109 – $109 |
| 11 | UnitedHealthcare unison advantage special needs facility · fee schedule · outpatient | $112 | $112 | — | — | — | $112 – $112 |
| 12 | Highmark managed care - social mission facility · fee schedule · outpatient | $155 | $155 | — | — | — | $155 – $155 |
| 13 | Highmark commercial - social mission indemnity facility · fee schedule · outpatient | $201 | $201 | — | — | — | $201 – $201 |
| 14 | Highmark managed care facility · fee schedule · outpatient | $207 | $207 | — | — | — | $207 – $207 |
| 15 | Highmark commercial - indemnity facility · fee schedule · outpatient | $270 | $270 | — | — | — | $270 – $270 |
| 16 | UnitedHealthcare compass exchange facility · percent of total billed charges · outpatientfrom % of charges | $348 | $348 | — | — | — | $348 – $348 |
| 17 | UnitedHealthcare compass exchange facility · percent of total billed charges · inpatientfrom % of charges | $359 | $359 | — | — | — | $359 – $359 |
| 18 | Aetna neighborhood network facility · percent of total billed charges · outpatientfrom % of charges | $371 | $371 | — | — | — | $371 – $371 |
| 19 | Aetna neighborhood network facility · percent of total billed charges · inpatientfrom % of charges | $380 | $380 | — | — | — | $380 – $380 |
| 20 | Aetna ebr fi facility · percent of total billed charges · inpatientfrom % of charges | $401 | $401 | — | — | — | $401 – $401 |
| 21 | Aetna ebr fi facility · percent of total billed charges · outpatientfrom % of charges | $401 | $401 | — | — | — | $401 – $401 |
| 22 | Aetna home depot employer group facility · percent of total billed charges · outpatientfrom % of charges | $403 | $403 | — | — | — | $403 – $403 |
| 23 | Aetna nbr aso/fi facility · percent of total billed charges · outpatientfrom % of charges | $412 | $412 | — | — | — | $412 – $412 |
| 24 | Cigna nbr aso/fi facility · percent of total billed charges · outpatientfrom % of charges | $412 | $412 | — | — | — | $412 – $412 |
| 25 | Cigna new business aso facility · percent of total billed charges · outpatientfrom % of charges | $412 | $412 | — | — | — | $412 – $412 |
Last updated: Mar 6, 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.