76857

Limited ultrasound scan of pelvis

Medicare pricing data for 28,740 providers across 52 states

🤖AI Overview

Prices vary significantly by location — from $24 in Maine to $51 in New Jersey. Where you get this procedure matters more than almost any other factor. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.

💡 What You Should Know

Limited ultrasound scan of pelvis (HCPCS code 76857) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $39.52, but hospitals typically charge $186.24 — a 4.7x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$7.90

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $39.52, your out-of-pocket cost would be approximately $7.90. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$39.52
Average Hospital Charge
$186.24
Markup Ratio
4.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$186.24
Medicare Allowed$39.52
Medicare Payment$29.45

Hospitals charge 4.7x more than what Medicare allows for this procedure. Medicare actually pays $29.45 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New Jersey$51$25298224,112+28.0%
California$47$2422,98932,526+19.0%
Puerto Rico$46$5434231+17.2%
New York$46$1932,10129,507+16.2%
Maryland$42$1636586,448+6.2%
Arizona$41$2345524,444+4.3%
Mississippi$40$1642423,719+1.0%
Florida$39$1612,05121,048-0.2%
Alaska$39$26188258-2.1%
Hawaii$38$16894531-3.2%
Georgia$37$1975862,984-6.3%
Connecticut$37$1545032,696-7.2%
Rhode Island$36$192126501-8.8%
Nevada$36$2302721,209-9.1%
Wyoming$35$19550156-10.7%
District of Columbia$35$164114716-11.4%
Utah$34$147154655-13.3%
Virginia$34$1486884,199-13.3%
Texas$34$1781,90010,045-13.9%
Washington$34$1166372,842-14.8%
Delaware$33$11970369-16.8%
Pennsylvania$32$1211,3317,215-18.8%
Colorado$31$1416052,421-20.7%
North Carolina$31$1578332,474-21.6%
Michigan$31$1317803,758-21.6%
New Mexico$31$202151729-22.5%
Arkansas$30$1252491,011-23.1%
Kansas$30$1682971,220-23.8%
South Carolina$29$2073921,121-25.6%
Massachusetts$29$1509425,046-26.3%
Indiana$29$1444311,460-26.4%
Illinois$29$1571,1555,293-27.0%
Iowa$29$154259953-27.2%
Tennessee$29$1455592,185-27.5%
Minnesota$28$1488562,339-28.0%
West Virginia$28$128147801-28.6%
Louisiana$28$1263631,442-29.5%
Alabama$28$104315973-29.5%
Nebraska$28$1162631,156-29.7%
Kentucky$27$972772,021-30.5%
Wisconsin$27$2646562,003-30.8%
New Hampshire$27$129179567-31.1%
Vermont$27$11151195-31.8%
Missouri$27$1285401,835-32.3%
Montana$26$10388355-33.0%
Ohio$26$1379653,936-33.1%
Oregon$26$1073791,756-33.6%
Idaho$26$157144512-34.1%
South Dakota$26$86103311-35.2%
Oklahoma$26$122264923-35.3%
North Dakota$25$11997433-36.8%
Maine$24$96154474-40.2%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber