How Much Does an Ultrasound Pelvis Cost in Massachusetts?
Us exam pelvic complete
$139Hospital outpatient total2026 Medicare, physician + facilityUnder 2026 Medicare rates, an ultrasound pelvis costs up to about $139 in total at a hospital outpatient department, counting both the physician and the facility (national rates). Outside a hospital, at an independent imaging center, lab or office, Medicare's full rate in Massachusetts averages $116, from $110 in Rest of Massachusetts to $122 in Metropolitan Boston.
- ✓Your ZIP's wage-adjusted hospital and surgery center rates
- ✓Five nearby hospitals by name, with CMS star ratings
- ✓The add-on codes that typically land on the bill
- ✓A word-for-word script for asking for a good-faith estimate
- ✓A private link you can reopen and share
- ✓Everything in the Premium report
- ✓15 nearby hospitals instead of five
- ✓Filled good-faith-estimate request letter
- ✓Bill-negotiation letter
- ✓Printable PDF download
Massachusetts Medicare physician rate (2026)
+9.9% vs nationalAverage of 2 localities. Office range $109.53–$121.69.
What the whole procedure costs
The office rate above is what an imaging center, lab or office is paid for the whole test. In a hospital, the facility bills its own fee and the physician bills only the reading. These are 2026 national Medicare amounts.
Medicare may pay the facility separately for this code or package it into another service on the same day, so treat the facility share as an upper bound. For a test like this the physician in a hospital bills only the reading (the professional component); outside a hospital one global fee covers the whole test, shown in the office rate above. Medicare allowed amounts are not what an uninsured patient is charged, and not a quote. Private plans typically allow more.
Your ZIP in Massachusetts
Look up your ZIP to see whether metro Boston or rest-of-state pricing applies, from Boston and Cambridge to Worcester, Springfield, the North and South Shores, and Cape Cod.
What ultrasound pelvis costs at hospitals near you
Everything above is a national average. The hospital you pick in Massachusetts moves the bill more than anything else you control.
Rates for your ZIP, 5 named hospitals with CMS ratings, the add-on codes, and the scheduler script.
For example 01001.
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What these numbers are
Every figure on this page is a 2026 Medicare allowed amount: the physician line comes from the Physician Fee Schedule adjusted by geographic practice-cost indices, and the facility totals come from the CMS hospital outpatient (OPPS) and ambulatory surgery center rates. None of them is a hospital chargemaster price, your insurer's contracted rate, or a quote. Anesthesia, pathology, imaging reads and follow-up care are billed under their own codes when they apply, and an inpatient stay is paid a different way again. In Massachusetts the office and hospital physician lines for this CPT differ by $81.71.
National vs Massachusetts
Where Massachusetts ranks for this CPT
CPT 76856 by Massachusetts locality
| Locality | Office |
|---|---|
| metropolitan boston | $121.69 |
| rest of massachusetts | $109.53 |
PE GPCI ranges from 1.053 to 1.194 in Massachusetts. That index is why the same CPT is not one price statewide.
Ultrasound Pelvis and how Massachusetts is priced
Massachusetts is priced through two localities: metro Boston and the rest of the state. Boston's locality carries clearly higher geographic adjustments, reflecting some of the highest medical wages and office costs in the nation, while Worcester, Springfield, and the Cape share the lower rest-of-state factors. The split means the fee schedule itself acknowledges what everyone in the state already knows about Boston prices. Even so, rest-of-state Massachusetts still prices above most of the country.
Boston has arguably the densest concentration of academic medical centers anywhere, and its teaching hospitals pull referrals from all of New England and beyond. That prestige comes with a high-cost market structure that state policymakers have scrutinized for years. Western Massachusetts operates more like a regional market centered on Springfield, and Cape and islands residents contend with seasonal capacity strain.
This procedure: A complete pelvic ultrasound scans the bladder, uterus, and ovaries through the lower abdomen using a probe on the skin, requiring a full bladder to push bowel out of the way and create a clear acoustic window. It evaluates pelvic pain, fibroids, and masses, and in males or by protocol it examines the bladder and surrounding structures. The exam takes 15 to 30 minutes; the full-bladder requirement is most patients' only complaint.
What Is Ultrasound Pelvis?
A complete pelvic ultrasound scans the bladder, uterus, and ovaries through the lower abdomen using a probe on the skin, requiring a full bladder to push bowel out of the way and create a clear acoustic window. It evaluates pelvic pain, fibroids, and masses, and in males or by protocol it examines the bladder and surrounding structures. The exam takes 15 to 30 minutes; the full-bladder requirement is most patients' only complaint.
What Affects the Cost
- –It is commonly paired with a transvaginal study (76830) in one appointment, producing two billed exams.
- –Hospital imaging departments price this study well above independent centers and office-based machines.
- –An inadequately filled bladder can force rebooking, effectively costing a second visit.
- –A limited pelvic ultrasound is a cheaper code when only one structure needs a follow-up look.
- –Separate professional reading fees apply where radiologists interpret off-site.
Questions to Ask Before Booking
- 1.Is a complete study needed, or is this a follow-up that qualifies for the cheaper limited code?
- 2.Will a transvaginal exam likely be added during the visit, and what would both together cost?
- 3.What are the bladder-filling instructions so I am not rebooked?
- 4.What is the price difference between your office, an imaging center, and the hospital?
- 5.What diagnosis is on the order to support coverage?
Other featured procedures in Massachusetts
Ultrasound Pelvis in other states
Ultrasound Pelvis in Massachusetts: questions
Under 2026 Medicare rates, an ultrasound pelvis costs up to about $139 in total at a hospital outpatient department, counting both the physician and the facility (national rates). Outside a hospital, at an independent imaging center, lab or office, Medicare's full rate in Massachusetts averages $116, from $110 in Rest of Massachusetts to $122 in Metropolitan Boston. Enter a ZIP for the exact Massachusetts locality.
Yes. CMS splits Massachusetts into 2 payment localities. For this CPT the office physician fee spans $12.16 from the lowest to highest locality. Look up your ZIP to see whether metro Boston or rest-of-state pricing applies, from Boston and Cambridge to Worcester, Springfield, the North and South Shores, and Cape Cod.
After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $23 for the office physician line or $7 for the hospital physician line in Massachusetts. Medigap may cover that 20%. This is not the hospital facility fee.
It depends on where the test is done. At an independent imaging center, lab or office, $115.61 is Medicare's full rate in Massachusetts, covering the test and the reading. In a hospital outpatient department the physician is paid only for the reading (about $33.90) and the hospital is paid separately, which brings the national total to up to about $139. Massachusetts ranks #45 of 51 states on the non-hospital rate (10% above the national office rate of $105.21).