Scans and imaging CPT 76857 Outpatient

Pelvic ultrasound (limited) cost in Belfast, ME

In Belfast, ME, 1 hospital lists a cash price for pelvic ultrasound (not pregnancy), limited or follow-up: from $45.85 to $45.85, with a median of $45.85. Across Maine, the median is $109.80 at 17 hospitals.

Cash prices at 1 facility 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 Sep 9, 2025 and Sep 9, 2025.

Lowest$45.85MaineHealth
Median$45.85half pay less
Highest$45.85in this market
Difference1.0×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 Belfast, ME.

median
Lowest $45.85Highest $435.95

Hospitals, cheapest first

HospitalCash price List priceInsurers payOff listFile date
MaineHealth lowest Belfast, ME · (207) 338-2500 CHG US PELVIC NONOBSTETRIC IMAGE DCMTN LIMITED/F/U $45.85 $45.85 $18.42–$522.49 — Sep 9, 2025
source file
MaineHealth Belfast, ME · (207) 338-2500 CHG US PELVIC NONOBSTETRIC IMAGE DCMTN LIMITED/F/U $86.00 $86.00 $43.00–$195.39 — Sep 9, 2025
source file
MaineHealth Belfast, ME · (207) 338-2500 HC US PELVIC LIMITED OR F/U REAL TIME $435.95 $435.95 $175.12–$522.49 — Sep 9, 2025
source file

Outpatient: lowest $45.85, median $45.85, highest $45.85.

As an inpatient, the same code is billed by 1 facility here, median $45.85. 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 the one hospital here that publishes insurer rates for this code, the cash price is below the highest rate a health plan has negotiated. 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.