Price of Limited Pelvic Ultrasound at NYU Langone
Last Updated: 2024-07-01
Locations
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NYU Langone|Tisch Hospital
550 1st Ave., New York, NY 10016About Limited Pelvic Ultrasound
Service Codes: CPT 76857, LOCAL 2021155
This procedure uses sound waves to create images of the pelvic organs, helping to assess conditions such as ovarian cysts or uterine abnormalities.
Pricing Overview
Cash Price
$271.55
Median Price
$213.78
Price Range
$27.08 - $1,286.28
Insurance Plan Prices
| Insurance Provider | Plan Type | Price |
|---|---|---|
| Blue Cross Blue Shield | UniCare | $492.46 |
| EmblemHealth | Healthcare Partners Essential Plan 3 | $213.78 |
| Blue Cross Blue Shield | MediBlue (Medicare Advantage) HMO (HCP) | $130.93 |
| BCBS (Out of State) | POS (Suitcase Logo) | $492.46 |
| BCBS (Out of State) | HMO (No Suitcase Logo) | $492.46 |
| Fidelis Care | Essential Plan 2 | $459.63 |
| EmblemHealth | WLNY-TV | $53.15 |
| MetroPlus | Gold | $457.49 |
| UnitedHealthcare | AARP Medicare Advantage Complete Essentials | $130.93 |
| Anthem BCBS HealthPlus | Medicaid | $213.78 |
| MultiPlan | Guardian Life Insurance Co | $1,114.78 |
| UnitedHealthcare | AARP | $130.93 |
| EmblemHealth | GHI EPO | $53.15 |
| EmblemHealth | Essential Plan 2 | $256.54 |
| Healthfirst | Essential Plan 3 | $27.08 |
| Anthem BCBS HealthPlus | SOMOS Child Health Plus (CHP) | $224.47 |
| Blue Cross Blue Shield | POS | $492.46 |
| MagnaCare | Cement & Concrete Workers District Council | $191.31 |
| CenterLight | PACE Medicare HMO | $133.55 |
| Blue Cross Blue Shield | Pathway Enhanced | $256.54 |
| Blue Cross Blue Shield | Global Transplants | $492.46 |
| UnitedHealthcare | AARP Medicare Advantage Complete | $130.93 |
| Fidelis Care | Bronze for Children (Exchange) | $384.81 |
| EmblemHealth | Healthcare Partners Essential Plan 2 | $256.54 |
| EmblemHealth | Select Care PPOu00a0 | $59.80 |
| VA Community Care Network | Optum | $130.93 |
| UnitedHealthcare | Choice | $446.00 |
| Aetna | Open Access HMO | $153.94 |
| MultiPlan | PHCS Savility | $1,114.78 |
| MultiPlan | Global Health Management | $1,114.78 |
| EmblemHealth | HIP VIP Medicare Healthcare Partners | $130.93 |
| Blue Cross Blue Shield | Blue Priority PPO | $492.46 |
| EmblemHealth | Enhanced Care (Medicaid) Child Health Plus (SOMOS) | $224.47 |
| EmblemHealth | GHI Comprehensive Benefits Plan (CBP) | $53.15 |
| Aetna | HMO | $153.94 |
| EmblemHealth | Vytra HMO | $70.35 |
| EmblemHealth | Healthcare Partners Essential Plan 3-4 | $213.78 |
| MultiPlan | PHP Healthcare (Champus) | $1,114.78 |
| EmblemHealth | Enhanced Care (Medicaid) | $213.78 |
| GEHA | All Plans | $153.94 |
| EmblemHealth | Enhanced Care (Medicaid) Essential Plan 2 (SOMOS) | $288.61 |
| EmblemHealth | GHI Medicare HMO | $130.93 |
| Fidelis Care | Wellcare Medicare Advantage | $130.93 |
| EmblemHealth | Prime Platinum | $59.80 |
| Blue Cross Blue Shield | Child Health Plus (CHP) | $213.78 |
| MetroPlus | Essential Plan 2 | $213.78 |
| Cigna | MVP-Cigna Network | $95.87 |
| BCBS (Out of State) | PPO | $492.46 |
| EmblemHealth | GHI PPO | $53.15 |
| Blue Cross Blue Shield | Senior Care Supplemental | $130.93 |
| MagnaCare | JIB Members | $191.31 |
| VNS Health | MLTC (Medicaid) | $169.76 |
| Blue Cross Blue Shield | Open Access HMO (Home-based Only) | $492.46 |
| VNS Health | EasyCare (Medicare Advantage) | $130.93 |
| Elderplan | FIDA | $130.93 |
| Health Net | PPO | $1,114.78 |
| Fidelis Care | Silver for Children (Exchange) | $384.81 |
| EmblemHealth | American Plan Administrators | $53.15 |
| Anthem BCBS | Empire Plan, Value Options | $492.46 |
| BCBS (Out of State) | EPO (No Suitcase Logo) | $492.46 |
| MetroPlus | BronzePlus | $43.32 |
| Fidelis Care | Platinum for Children (Exchange) | $384.81 |
| Aetna | Allied ASA PPO | $153.94 |
| Veterans Choice | Veterans Choice Program | $130.93 |
| UnitedHealthcare | POMCO (UMR) | $446.00 |
| MultiPlan | Principal Financial Group | $1,114.78 |
| EmblemHealth | Prime Bronze | $59.80 |
| EmblemHealth | HIP VIP Medicare Reserve | $130.93 |
| EmblemHealth | Select Care Healthcare Partners | $59.80 |
| Aetna | Signature Administrators PPO | $153.94 |
| EmblemHealth | VIP Prime HMO Medicare Advantage | $130.93 |
| MetroPlus | Essential Plan 3-4 | $213.78 |
| Fidelis Care | Essential Plan 1 | $459.63 |
| MagnaCare | Direct Plus Preferred | $191.31 |
| MultiPlan | Kaiser Permanente | $1,114.78 |
| HealthSmart | WTC Health Program - UMDNJ Rutgers | $130.93 |
| Partners Health Plan | Medicare Advantage | $130.93 |
| Aetna | Student Health | $153.94 |
| MetroPlus | Medicare Advantage | $130.93 |
| Healthfirst | Child Health Plus (CHP) | $27.08 |
| Anthem BCBS | All Plans | $492.46 |
| Blue Cross Blue Shield | Blue Access EPO (Small Group) | $393.97 |
| Elderplan | All Plans | $130.93 |
| BCBS (Out of State) | Medicare (Suitcase Logo) | $130.93 |
| EmblemHealth | Healthcare Partners Essential Plan 1-2 | $256.54 |
| VillageCareMAX | All Plans | $130.93 |
| MagnaCare | Direct Plus | $191.31 |
| Cigna | NALC PPO | $95.87 |
| MultiPlan | Humana Health Plan | $1,114.78 |
| MultiPlan | QualCare Inc | $1,114.78 |
| Cigna | Great West HMO | $95.87 |
| MultiPlan | Paramount Insurance | $1,114.78 |
| Cigna | Wellfleet Student | $95.87 |
| MagnaCare | PPO | $191.31 |
| BCBS (Out of State) | Indemnity | $492.46 |
| UnitedHealthcare | Choice (North Shore - LIJ) | $446.00 |
| MagnaCare | American Plan Administrators | $191.31 |
| EmblemHealth | Select Care Basic Exchange | $59.80 |
| EmblemHealth | Bridge | $70.35 |
| EmblemHealth | Healthcare Partners Essential Plan 4 | $213.78 |
| HealthSmart | WTC Health Program - NYU | $130.93 |
| MetroPlus | GoldCare 2 | $457.49 |
| Cigna | Great West PPO | $95.87 |
| EmblemHealth | Select Care Bronze Small Group | $59.80 |
| Humana | All Commercial Plans | $1,114.78 |
| Partners Health Plan | Medicare Advantage (Home-based Only) | $130.93 |
| CenterLight | Select | $133.55 |
| Aetna | POS | $153.94 |
| EmblemHealth | GHI Behavioral Management Program | $53.15 |
| Blue Cross Blue Shield | Pathway | $256.54 |
| HealthSmart | WTC Health Program - Logistic Health Inc | $130.93 |
| BCBS (Out of State) | HMO (Suitcase Logo) | $492.46 |
| Aetna | Chesterfield Resources ASA PPO | $153.94 |
| EmblemHealth | Enhanced Care (Medicaid) (SOMOS) | $224.47 |
| Blue Cross Blue Shield | MediBlue (Medicare Advantage) HMO | $130.93 |
| BCBS (Out of State) | Medicare (No Suitcase Logo) | $130.93 |
| Fidelis Care | Native American (Exchange) | $384.81 |
| MultiPlan | PHCS Director Guild | $1,114.78 |
| 1199SEIU Funds | PPO | $315.90 |
| Blue Cross Blue Shield | MediBlue (Medicare Advantage) PPO | $130.93 |
| Fidelis Care | Silver 250 (Exchange) | $384.81 |
| MultiPlan | Fiserv Health | $1,114.78 |
| MultiPlan | Nippon Life | $1,114.78 |
| Blue Cross Blue Shield | Blue Priority HMO | $492.46 |
| BCBS (Out of State) | Medicare | $130.93 |
| Blue Cross Blue Shield | Open Access PPO (Home-based Only) | $492.46 |
| CenterLight | PACE | $133.55 |
| EmblemHealth | GHI Medicare PPO | $130.93 |
| MetroPlus | Essential Plan 1 | $213.78 |
| EmblemHealth | Prime Gold | $59.80 |
| EmblemHealth | HIP SmartStart | $70.35 |
| UnitedHealthcare - Oxford | Metro | $314.00 |
| Anthem BCBS HealthPlus | Medicare Advantage | $130.93 |
| Aetna | Open Access Elect Choice EPO | $153.94 |
| Blue Cross Blue Shield | Pathway X Enhanced | $256.54 |
| Anthem BCBS HealthPlus | SOMOS ny medicaid | $224.47 |
| Aetna | Meritain Health | $153.94 |
| EmblemHealth | Select Care Platinum Exchange | $59.80 |
| MultiPlan | Administrative Concepts | $1,114.78 |
| Fidelis Care | Essential Plan 4 | $265.09 |
| MetroPlus | SilverPlus | $43.32 |
| EmblemHealth | Select Care HMO | $59.80 |
| Aetna | Nippon Life ASA PPO | $153.94 |
| MultiPlan | Capital District Physicians Health Plan | $1,114.78 |
| Blue Cross Blue Shield | Blue Access EPO (Large Group) | $443.21 |
| Blue Cross Blue Shield | PPO | $492.46 |
| EmblemHealth | HIP Access I | $70.35 |
| Cigna | Tufts Health Plan | $95.87 |
| BCBS (Out of State) | PPO (No Suitcase Logo) | $492.46 |
| Fidelis Care | Gold (Exchange) | $384.81 |
| EmblemHealth | American Plan Administrators c/o H.D.A | $53.15 |
| EmblemHealth | Select Care EPO | $59.80 |
| Blue Cross Blue Shield | MediBlue (Medicare Advantage) Select HMO/Extra HMO | $130.93 |
| HealthSmart | WTC Health Program - FDNY | $130.93 |
| Aetna | Christian Brothers ASA PPO | $153.94 |
| Aetna | Indemnity | $1,157.65 |
| Anthem BCBS HealthPlus | Essential Plan 1, 200-250 | $427.56 |
| EmblemHealth | HIP Prime Basic | $59.80 |
| Anthem BCBS HealthPlus | SOMOS Essential Plan 3 | $224.47 |
| Anthem BCBS HealthPlus | Essential Plan 4 | $213.78 |
| EmblemHealth | HIP EPO | $70.35 |
| EmblemHealth | HIP VIP Medicare Montefiore | $130.93 |
| MultiPlan | Screen Actors Guild | $1,114.78 |
| EmblemHealth | HIP HMO | $70.35 |
| HealthSmart | WTC Health Program - NYCHHC | $130.93 |
| UnitedHealthcare | POMCO (UMR) | $1,114.78 |
| Carelon Behavioral Health | Medicaid Managed Care (Home-based Only) | $169.76 |
| Maksin Group | Consolidated Health Plan (Home-based only) | $95.87 |
| VNS Health | Total (Medicare + Medicaid) | $130.93 |
| EmblemHealth | HIP compre health | $70.35 |
| UnitedHealthcare | WTC Health Program | $130.93 |
| Fidelis Care | Silver (Exchange) | $384.81 |
| Aetna | Coresource ASA PPO | $153.94 |
| EmblemHealth | Enhanced Care (Medicaid) Healthcare Partners | $213.78 |
| MagnaCare | National Health Plan | $191.31 |
| Cigna | PPO | $95.87 |
| UnitedHealthcare | Optum Health | $446.00 |
| UnitedHealthcare | Student Resources | $446.00 |
| UnitedHealthcare | Choice (NY Power Authority) | $446.00 |
| 1199SEIU Funds | Member Choice Home Care Select | $315.90 |
| Hamaspik | Medicare Advantage | $196.39 |
| Healthfirst | Essential Plan 3-4 | $27.08 |
| Fidelis Care | Catastrophic (Exchange) | $384.81 |
| CenterLight | Direct | $133.55 |
| MultiPlan | Healthnet of California | $1,114.78 |
| MultiPlan | PHCS | $1,114.78 |
| AgeWell (Deprecated) | Medicaid Managed Care | $169.76 |
| Cigna | Open Access | $95.87 |
| Senior Whole Health | All Plans | $130.93 |
| EmblemHealth | Healthcare Partners Essential Plan 1, 200-250 | $256.54 |
| Healthfirst | Personal Wellness Plan (HARP) | $169.76 |
| Aetna | Starmark ASA PPO | $153.94 |
| EmblemHealth | HIP Access II | $70.35 |
| UnitedHealthcare | Medicare Advantage Complete Choice Regional PPO | $130.93 |
| MetroPlus | PlatinumPlus | $43.32 |
| EmblemHealth | HIP Child Health Plus | $213.78 |
| MetroPlus | GoldPlus | $43.32 |
| Blue Cross Blue Shield | Indemnity | $492.46 |
| BCBS (Out of State) | PPO (Suitcase Logo) | $492.46 |
| EmblemHealth | CMO Essential Plan 2 | $256.54 |
| UnitedHealthcare | EPO | $446.00 |
| MultiPlan | Mutual of Omaha | $1,114.78 |
| EmblemHealth | Healthcare Partners Essential Plans | $256.54 |
| MetroPlus | MedPlus | $43.32 |
| EmblemHealth | HIP PPO | $70.35 |
| HealthSmart | WTC Health Program - Mt. Sinai | $130.93 |
| UnitedHealthcare - Oxford | Freedom | $314.00 |
| Cigna | Premier Plus | $95.87 |
| Amida Care | Medicaid Managed Care | $58.98 |
| Cigna | Indemnity | $95.87 |
| EmblemHealth | Essential Plan 1, 200-250 | $256.54 |
| Blue Cross Blue Shield | MediBlue (Medicare Advantage) Select/Extra HMO (HCP) | $130.93 |
| Cigna | LifeSOURCE | $95.87 |
| Better Health Plan | All Plans | $1,200.53 |
| BCBS (Out of State) | HMO | $492.46 |
| Healthfirst | Senior Health Partners (MLTC) | $27.08 |
| BCBS (Out of State) | EPO (Suitcase Logo) | $492.46 |
| EmblemHealth | HIP | $70.35 |
| Partners Health Plan | Medicaid MLTC | $169.76 |
| UnitedHealthcare | POS | $446.00 |
| Cigna | Cigna Managed Care/POS | $95.87 |
| Aetna | PPO | $153.94 |
| Anthem BCBS HealthPlus | Essential Plan 2 | $427.56 |
| Sedgwick | WTC Health Program - Northwell | $130.93 |
| MultiPlan | AXA Global Insurance | $1,114.78 |
| MultiPlan | PPO | $1,114.78 |
| Aetna | Healthscope ASA PPO | $153.94 |
| Anthem BCBS HealthPlus | Essential Plan 3 | $213.78 |
| Blue Cross Blue Shield | Hotel Trades Council | $492.46 |
| EmblemHealth | CMO Essential Plan 3 | $213.78 |
| Cigna | Evernorth Behavioral Health | $95.87 |
| EmblemHealth | Select Care Gold Small Group | $59.80 |
| UnitedHealthcare | Medicare Advantage | $130.93 |
| BCBS (Out of State) | EPO | $492.46 |
| EmblemHealth | HIP Optum Health | $70.35 |
| Blue Cross Blue Shield | Blue Priority EPO (Small Group) | $393.97 |
| EmblemHealth | HIP Montefiore | $70.35 |
| Fidelis Care | Medicaid Managed Care | $265.09 |
| UnitedHealthcare | AARP Medicare Advantage Complete Mosaic | $130.93 |
| MetroPlus | Medicaid Managed Care | $213.78 |
| UnitedHealthcare | Golden Rule Insurance | $446.00 |
| EmblemHealth | BCBS GHI Composite | $492.46 |
| Carelon Behavioral Health | All Exchange Plans (Home-based Only) | $130.93 |
| EmblemHealth | Enhanced Care (Medicaid) SNP HARP (SOMOS) | $224.47 |
| MultiPlan | Meritain Health | $1,114.78 |
| MagnaCare | Independent Care Plus | $191.31 |
| 1199SEIU Funds | Home Care Benefit Fund | $315.90 |
| Horizon BCBS | Direct | $492.46 |
| MetroPlus | Essential Plan 4 | $213.78 |
| Anthem BCBS HealthPlus | All Exchange Plans | $256.54 |
| Three Rivers | All Plans (Home-based Only) | $1,286.28 |
| Carelon Behavioral Health | Medicare Advantage (Home-based Only) | $130.93 |
| MagnaCare | Capital District Physicians Health Plan | $191.31 |
| Blue Cross Blue Shield | Blue Access PPO (Large Group) | $443.21 |
| Blue Cross Blue Shield | Federal Program | $492.46 |
| VNS Health | SelectHealth (Medicaid) | $169.76 |
| EmblemHealth | Select Care Gold Exchange | $59.80 |
| EmblemHealth | Essential Plan 4 | $213.78 |
| MultiPlan | Diversified Admin Corp | $1,114.78 |
| UnitedHealthcare | Core | $446.00 |
| EmblemHealth | Enhanced Care (Medicaid) Essential Plan 3 (SOMOS) | $224.47 |
| BCBS (Out of State) | POS (No Suitcase Logo) | $492.46 |
| UnitedHealthcare | Navigate | $446.00 |
| EmblemHealth | Select Care Catastrophic Exchangeu00a0 | $59.80 |
| Aetna | Global National Transplant | $153.94 |
| EmblemHealth | HIP Medicare Supplement | $130.93 |
| EmblemHealth | Prime Silver | $59.80 |
| UnitedHealthcare | Charter | $446.00 |
| Anthem BCBS HealthPlus | Child Health Plus (CHP) | $213.78 |
| EmblemHealth | Select Care Silver Exchange | $59.80 |
| MultiPlan | Teamsters Allied Benefits | $1,114.78 |
| Riverspring Health Plans | Medicare Advantage | $130.93 |
| Fidelis Care | Gold for Children (Exchange) | $384.81 |
| EmblemHealth | HIP compre health epo | $70.35 |
| Partners Health Plan | Medicaid | $169.76 |
| Partners Health Plan | FIDA | $130.93 |
| EmblemHealth | HIP POS | $70.35 |
| First Health | PPO | $1,114.78 |
| Fidelis Care | Essential Plan 3 | $265.09 |
| MultiPlan | Global Excel Management | $1,114.78 |
| MetroPlus | Essential Plan 3 | $213.78 |
| MetroPlus | Essential Plan 1-2, 200-250 | $213.78 |
| HealthSmart | WTC Health Program - Stony Brook | $130.93 |
| UnitedHealthcare - Oxford | Optum Health | $314.00 |
| BCBS (Out of State) | POS | $492.46 |
| EmblemHealth | HIP Long Island College Hospital (LICH) | $70.35 |
| UnitedHealthcare - Oxford | Liberty | $314.00 |
| Blue Cross Blue Shield | Local 32 BJ | $492.46 |
| UnitedHealthcare - Oxford | Medicare Advantage | $130.93 |
| Anthem BCBS | Optum | $492.46 |
| Anthem BCBS HealthPlus | Family Health Plus (Deprecated) | $213.78 |
| EmblemHealth | HIP Healthcare Partners HMO | $70.35 |
| UnitedHealthcare | HMO | $446.00 |
| Blue Cross Blue Shield | Blue Access gEPO (Large Group) | $443.21 |
| First Health | Commercial HMO | $1,200.53 |
| Cigna | Open Access PPO | $95.87 |
| EmblemHealth | HIP VIP Medicare Affinity | $130.93 |
| EmblemHealth | GHI composite | $53.15 |
| EmblemHealth | Enhanced Care (Medicaid) Essential Plan 4 (SOMOS) | $224.47 |
| AgeWell (Deprecated) | Medicare Advantage | $130.93 |
| Anthem BCBS HealthPlus | SOMOS Essential Plan 1 & 200-250 | $288.61 |
| HealthSmart | WTC Health Program - Northwell | $130.93 |
| Aetna | Wellnet ASA PPO | $153.94 |
| EmblemHealth | Select Care Bronze Exchange | $59.80 |
| Blue Cross Blue Shield | PPO/EPO (Small Group) | $393.97 |
| EmblemHealth | IUOE Local 14-14B | $53.15 |
| Cigna | Open Access HMO | $95.87 |
| Anthem BCBS HealthPlus | SOMOS Special Needs HARP | $224.47 |
| MagnaCare | JIB Employees Security Fund | $191.31 |
| Fidelis Care | Bronze (Exchange) | $384.81 |
| Anthem BCBS HealthPlus | SOMOS Essential Plan 4 | $224.47 |
| EmblemHealth | Essential Plan 3 | $213.78 |
| Centers Plan for Healthy Living | All Plans | $130.93 |
| Blue Cross Blue Shield | HMO | $492.46 |
| EmblemHealth | Select Care Silver Small Group | $59.80 |
| EmblemHealth | Enhanced Care (Medicaid) Essential Plan 1, 200-250 (SOMOS) | $288.61 |
| Blue Cross Blue Shield | Blue Connection | $492.46 |
| Anthem BCBS HealthPlus | Special Needs Plan (SNP) | $213.78 |
| Blue Cross Blue Shield | Healthy New York | $492.46 |
| Fidelis Care | Platinum (Exchange) | $384.81 |
| EmblemHealth | GHI HMO | $53.15 |
| VNS Health | EasyCare Plus (Medicare+Medicaid) | $130.93 |
| Anthem BCBS HealthPlus | SOMOS Essential Plan 2 | $288.61 |
| EmblemHealth | GHI Medicare Supplement | $130.93 |
| Blue Cross Blue Shield | Blue Access EPO (Large Group) (NY LI Local 1199SEIU) | $443.21 |
| EmblemHealth | Select Care Platinum Small Group | $59.80 |
| Healthfirst | Essential Plan 4 | $27.08 |
| EmblemHealth | CMO Essential Plan 1 | $256.54 |
| Blue Cross Blue Shield | EPO | $492.46 |
| Healthfirst | Personal Wellness Plan (HARP) | $27.08 |
| Cigna | HMO | $95.87 |
| EmblemHealth | CMO Essential Plan 4 | $213.78 |
| UnitedHealthcare | Independent | $446.00 |
| Aetna | Medicare Advantage | $130.93 |
| Healthfirst | Medicaid Managed Care | $27.08 |
| UnitedHealthcare | PPO | $446.00 |
| EmblemHealth | HIP VIP Medicare Bold | $130.93 |
| Blue Cross Blue Shield | Blue Access HMO (Small Group) | $393.97 |
| Fidelis Care | Child Health Plus (CHP) | $265.09 |
| MetroPlus | Child Health Plus (CHP) | $213.78 |
| EmblemHealth | Enhanced Care (Medicaid) Montefiore | $213.78 |
| Blue Cross Blue Shield | Blue Access gEPO (Small Group) | $393.97 |
| Champus | Unysis Corp | $130.93 |
| MultiPlan | US Life Insurance Co | $1,114.78 |