Scans and imaging CPT 76857 Outpatient

Pelvic ultrasound (limited) cost in San Jose, CA

In San Jose-Sunnyvale-Santa Clara, CA, 5 hospitals list a cash price for Pelvic ultrasound (not pregnancy), limited or follow-up: from $203.50 to $1,205.50, with a median of $616.00. The lowest listed price is at Stanford Health Care — $412.50 less than the median here. Across California, the median is $520.00 at 100 hospitals.

Cash prices at 5 facilities across 5 cities for code 76857, as an outpatient — the setting a self-pay patient normally buys. Collected Sep 23, 2026; the hospital files themselves were last updated between Mar 31, 2026 and Apr 1, 2026.

Lowest$203.50Stanford Health Care
Median$616.00half pay less
Highest$1,205.50in this market
Difference5.9×highest vs lowest

Where each hospital's price falls

Each dot is one hospital's cash price on a scale from the lowest to the highest in San Jose-Sunnyvale-Santa Clara, CA.

median
Lowest $203.50Highest $1,205.50

Hospitals, cheapest first

HospitalCash price List priceInsurers payOff listFile date
Stanford Health Care lowest Stanford, CA US Pel Nonob B-Scan&/R-T Img Lmtd/F-Up+C97 $203.50 $407.00 $61.74–$407.00 50% Apr 1, 2026
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Stanford Health Care lowest Stanford, CA US Pel Nonob B-Scan&/R-T Img Lmtd/F-Up+C97 $203.50 $407.00 $73.80–$407.00 50% Apr 1, 2026
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El Camino Hospital Mountain View, CA HC US PELVIS SCAN-LIMITED $347.00 $1,388.00 — 75% Apr 1, 2026
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Kaiser Foundation Hospital - Santa Clara Santa Clara, CA US PELVIC NONOBSTETRIC IMAGE DCMTN LIMITED/F/U $616.00 $1,100.00 $142.00–$445.00 44% —
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Kaiser Foundation Hospital - San Jose San Jose, CA US PELVIC NONOBSTETRIC IMAGE DCMTN LIMITED/F/U $616.00 $1,100.00 $142.00–$445.00 44% —
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Stanford Health Care Stanford, CA US Pelvic Non OB Ltd $962.40 $2,406.00 — 60% Apr 1, 2026
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Stanford Health Care Stanford, CA US Pelv Non-OB Limited $962.40 $2,406.00 — 60% Apr 1, 2026
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Lucile Salter Packard Children's Hospital at Stanford Palo Alto, CA HC US Pelvis Limited $1,205.50 $2,411.00 $1,017.44–$1,171.50 50% Mar 31, 2026
source file

Outpatient: lowest $203.50, median $616.00, highest $1,205.50 — a 5.9× difference within the same market.

As an inpatient, the same code is billed by 4 facilities here, median $481.50. Inpatient and outpatient prices are not comparable and are kept on separate pages: the inpatient charge covers admission, not the same purchase.

Cash or insurance?

At 1 of 4 hospitals that publish insurer rates for this code here, the cash price is below the highest rate a health plan has negotiated, and at none is it below every plan's rate. If you have insurance but have not met your deductible, you usually pay your plan's negotiated rate, which falls somewhere in the "Insurers pay" column. Paying cash can cost less, but a cash payment usually does not count toward your deductible. Ask the hospital for both numbers before you book.

What it is

A limited pelvic ultrasound looks at one question in the pelvis, such as following up an ovarian cyst or checking the bladder.

What the price covers

The price usually covers the scan. The radiologist's reading may be billed separately.