CMS Price Transparency Data

Ultrasound, pelvis

Facility: Oroville Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $122
Cash Discount Price: $370
vs. Medicare Baseline: 1.14x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Oroville Hospital is $122. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $370. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.14x the Medicare baseline. Located in 2767 Olive Highway, Oroville, CA.

Cash / Self-Pay

$370

Average discount available for prompt cash payment at this facility.

Insurance Median

$122

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: $370 (346%)

Insurance Median: $122 (114%)

Cash: $370 (346% of Medicare)

Ins. Median: $122 (114% 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
Blue Cross Blue Shield	$34 - $1,488	32%
Butte County	$44 - $471	41%
Cigna	$101 - $1,082	95%
Coventry Health Care	$101 - $1,082	95%
Health Net	$101 - $1,082	95%
Multiplan	$101 - $1,082	95%
Aetna	$105	98%
Community Care	$105	98%
Nivano Physicians Inc	$105	98%
UnitedHealthcare	$105 - $1,150	98%
Interplan	$107 - $1,150	100%
Three Rivers Provider Network	$107 - $1,150	100%
Beech Street	$113 - $1,218	106%
Healthstar	$113 - $1,218	106%
River City Medical Group	$115	108%
Health Payors Organization	$120 - $1,285	112%
Blue Shield Of California	$122 - $1,312	114%
Partnership Healthplan Of California	$173	162%
Blue Shield Value Network	$183	171%

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 $370.
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 Oroville Hospital 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.