Who reviews prior authorization requests for Ultrasound imaging of blood flow in the abdomen and pelvis area (CPT 93976)?

Most commercial payers hand imaging reviews to a radiology benefit manager. For the payers tracked here, requests are reviewed using guidelines from eviCore, Carelon, CMS, UnitedHealthcare / eviCore. The request is submitted through that organization's portal rather than the health plan's general line.

What should be in the clinical notes before requesting Ultrasound imaging of blood flow in the abdomen and pelvis area (CPT 93976)?

Reviewers look for a recent office visit that documents the symptoms and how long they have lasted, exam findings, results of any earlier imaging, treatments already tried and how the patient responded, and the specific question the study is expected to answer. The diagnosis code on the request should match what the notes describe.

CPT 93976: Ultrasound imaging of blood flow in the abdomen and pelvis area - Prior Authorization and Price

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CPT 93976

Ultrasound imaging of blood flow in the abdomen and pelvis area.

Cardiac & Vascular Testing

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Payer guidelines that apply

Payer	Reviewed using	Guideline	Sections
Aetna	eviCore	Pelvis Imaging Guidelines 2.0.2026, effective Sep 1, 2026 Peripheral Vascular Disease (PVD) Imaging Guidelines 2.0.2026, effective Sep 1, 2026 Abdomen Imaging Guidelines 1.0.2026, effective Feb 3, 2026 Pediatric Abdomen Imaging Guidelines 2.0.2026, effective Sep 1, 2026	31 that name this code
Anthem BCBS	Carelon	Current guideline	None found
Cigna	eviCore	Pelvis Imaging Guidelines 2.0.2026, effective Sep 1, 2026 Peripheral Vascular Disease (PVD) Imaging Guidelines 2.0.2026, effective Sep 1, 2026 Abdomen Imaging Guidelines 1.0.2026, effective Feb 3, 2026 Pediatric Abdomen Imaging Guidelines 2.0.2026, effective Sep 1, 2026	30 that name this code
Medicare	CMS	—	None found
Original Medicare does not run a prior authorization program for outpatient imaging; claims are judged against the coverage policies above. Medicare Advantage plans set their own prior authorization rules.
UnitedHealthcare	UnitedHealthcare / eviCore	Commercial and Exchange Cardiovascular and Radiology Imaging Guidelines 09.2026, effective Sep 1, 2026	31 that name this code

Guidelines collected from the payers' published documents on September 29, 2026. Payers revise these documents during the year. Open the guideline link to confirm the current version before you submit.

Conditions the guidelines address for this study

These are the clinical situations where payer guidelines discuss Ultrasound imaging of blood flow in the abdomen and pelvis area. Each has its own criteria for when the study is considered appropriate.

Abnormal Uterine Bleeding Aetna · Cigna · UnitedHealthcare
Adnexal Mass/Ovarian Cysts Aetna · Cigna · UnitedHealthcare
Scrotal Pathology Aetna · Cigna · UnitedHealthcare
Fetal MRI and Other Pregnancy Imaging Aetna · Cigna · UnitedHealthcare
Adenomyosis Aetna · Cigna · UnitedHealthcare
Leiomyoma/Uterine Fibroids and other Uterine Masses Aetna · Cigna · UnitedHealthcare
Pelvic Inflammatory Disease (PID) Aetna · Cigna · UnitedHealthcare
Pelvic Pain/Dyspareunia, Female Aetna · Cigna · UnitedHealthcare
Penis–Soft Tissue Mass Aetna · Cigna · UnitedHealthcare
Renovascular Hypertension and Other Secondary Causes of Hypertension Aetna · Cigna · UnitedHealthcare
Disorders of the Aorta and Visceral Arteries Aetna · Cigna · UnitedHealthcare
Liver Disease Aetna · Cigna · UnitedHealthcare
Liver Lesion Characterization Aetna · Cigna · UnitedHealthcare
Median Arcuate Ligament Syndrome, Nutcracker Syndrome and other Abdominal Vascular Compression Syndromes Aetna · Cigna · UnitedHealthcare
Mesenteric/Colonic Ischemia Aetna · Cigna · UnitedHealthcare
Pediatric Leukemias Aetna · Cigna · UnitedHealthcare
Renal Failure Aetna · Cigna · UnitedHealthcare
Screening for Peripheral Artery /Aneurysmal Disease Aetna · Cigna · UnitedHealthcare
Transplant Aetna · Cigna · UnitedHealthcare

Typical price

Commercial insurance, median

$395

Middle half of rates: $213 to $737

Medicare, hospital outpatient

$107

Facility payment

Medicare, physician fee schedule

$157

National, non-facility

Commercial figures come from negotiated rates published by 993 hospitals; Medicare figures from CMS fee schedules. Rates vary widely by hospital and plan. Pricing data from CenterIQ.

Get notified when the rules for this study change

Payers update imaging guidelines several times a year. We will email you when the criteria for Ultrasound imaging of blood flow in the abdomen and pelvis area change.

CPT 93976: Ultrasound imaging of blood flow in the abdomen and pelvis area - Prior Authorization and Price

Payer guidelines that apply

Conditions the guidelines address for this study

Typical price

Get notified when the rules for this study change

Frequently asked questions

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