CMS Price Transparency Data

Ultrasound, pelvis

Facility: Banner Ocotillo Medical Center

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $154
Cash Discount Price: $303
vs. Medicare Baseline: 1.44x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Banner Ocotillo Medical Center is $154. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $303. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.44x the Medicare baseline. Located in 1405 South Alma School Road, Chandler, AZ.

Cash / Self-Pay

$303

Average discount available for prompt cash payment at this facility.

Insurance Median

$154

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)

Cash / Self-Pay: $303 (284%)

Insurance Median: $154 (144%)

Cash: $303 (284% of Medicare)

Ins. Median: $154 (144% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $106.81 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Arizona Physicians Ipa	$79 - $113	74%
Banner University Health Plan	$79 - $113	74%
Health Choice Arizona, Inc.	$79 - $170	74%
Health Net	$79 - $168	74%
Mercy Care	$79 - $113	74%
Aetna	$113 - $447	106%
Banner Health	$113	106%
Blue Cross Blue Shield	$113 - $392	106%
Cigna	$113 - $532	106%
Gila River Health Care Corporation	$113	106%
Humana	$113 - $117	106%
Kaiser Foundation Health Plan	$113	106%
Triwest Healthcare Alliance Corp - Va Ccn	$113	106%
UnitedHealthcare	$113 - $159	106%
Upmc Health Plan	$113	106%
Wellpoint	$113	106%
Carelon	$119	111%
Devoted Health Services	$119	111%
Gold Kidney Health Plan	$125	117%
Oscar Health Plan	$187	175%
Hospice Of The Valley	$271	254%
Plotkin Health	$348	326%
Quiktrip Corporation	$418	391%
Arizona Medical Network	$542	507%
Provider Network Of America	$580	543%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $303.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 76856.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Banner Ocotillo Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 76856.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.