CMS Price Transparency Data
Ultrasound, pelvis
Facility: Adventist Health White Memorial
Billing Code: 76856 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 76856
- Insurance Median: $712
- Cash Discount Price: $538
- vs. Medicare Baseline: 6.67x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Adventist Health White Memorial is $712. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $538. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 6.67x the Medicare baseline. Located in 1720 Cesar E Chavez Avenue, Los Angeles, CA.
Cash / Self-Pay
$538
Average discount available for prompt cash payment at this facility.
Insurance Median
$712
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: $538 (504%)
Insurance Median: $712 (667%)
Cash: $538 (504% of Medicare)
Ins. Median: $712 (667% 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 667% of the Medicare baseline (a markup of 567%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Bc Medi-Cal | $50 | 47% |
| Blue Shield Mcr Adv | $85 | 80% |
| Access Medi-Cal | $97 | 91% |
| Ahp Medi-Cal | $97 | 91% |
| Alta Los Angeles Mcal 1/1/19 | $97 | 91% |
| Avanti Mcal | $97 | 91% |
| Bella Vista Medi-Cal Op/Profee Only | $97 | 91% |
| Healthcare Inc Medi-Cal | $97 | 91% |
| Lasalle Mg Medi-Cal | $97 | 91% |
| Medi-Cal | $97 | 91% |
| Molina Medi-Cal | $97 | 91% |
| Pacific Alliance Medi-Cal | $97 | 91% |
| Pacific Ipa Medi-Cal | $97 | 91% |
| Preferred Ipa La Care Mcal Cap | $97 | 91% |
| Preferred Medi-Cal | $97 | 91% |
| Altamed Medi-Cal - All Other Plans | $112 | 105% |
| Access Group | $114 | 107% |
| Ahp - All Other Plans | $114 | 107% |
| Lasalle Mg Commercial - All Other Plans | $114 | 107% |
| Fcs Ipa Medi-Cal Op/Profee Only | $116 | 109% |
| Healthnet Mcal | $116 | 109% |
| Preferred Healthy | $121 | 113% |
| Access Senior - All Other Plans | $134 | 125% |
| Ahp Senior | $134 | 125% |
| Alta Los Angeles Mcr 1/1/19-All Other Plans | $134 | 125% |
| Altamed Connect | $134 | 125% |
| Avanti Mcr Adv - All Other Plans | $134 | 125% |
| Brand New Day Mcare - All Plans | $134 | 125% |
| Bs Va Mcare | $134 | 125% |
| Care First Mcare - All Other Plans | $134 | 125% |
| Clever Care - All Plans | $134 | 125% |
| Fcs Ipa Mcr Advan Op/Profee Only | $134 | 125% |
| Humana | $134 | 125% |
| Lasalle Mg Senior | $134 | 125% |
| Medicare (plans) | $134 | 125% |
| Molina Mcare | $134 | 125% |
| Pacific Alliance Mcare - All Other Plans | $134 | 125% |
| Preferred Senior | $134 | 125% |
| Sunlight Living Hlth Mcr Adv-All Other Plans | $134 | 125% |
| Tricare | $134 | 125% |
| UnitedHealthcare | $134 - $1,496 | 125% |
| Assoc Hispanic Physcns Mcal | $136 | 127% |
| Blue Cross Blue Shield | $140 - $489 | 131% |
| Fcs Ipa Op/Profee Only - All Other Plans | $141 | 132% |
| Bright Health - All Plans | $155 | 145% |
| Assoc Hispanic Physcns Hmo/Mcr Adv-All Other Plans | $161 | 151% |
| Preferred Commercial - All Other Plans | $161 | 151% |
| Intergrated Medical - All Plans | $175 | 164% |
| Molina Benefit Exchange - All Other Plans | $182 | 170% |
| Php-Prospect Health Plan Cap - All Plans | $202 | 189% |
| Ah Employee Health Plan - All Plans | $242 | 227% |
| Blue Shield Medi-Cal | $243 | 228% |
| Centivo - All Plans | $303 | 284% |
| Care First Medi-Cal | $340 | 318% |
| Aetna | $416 | 389% |
| Cigna | $696 | 652% |
| Blue Shield Epn | $712 | 667% |
| Blue Shield - All Other Plans | $828 - $829 | 775% |
| Pacific Ipa - All Other Plans | $1,136 - $1,137 | 1064% |
| Kaiser- All Plans | $1,226 - $1,227 | 1148% |
| Western Growers/Pinnacle - All Plans | $1,226 - $1,227 | 1148% |
| Healthnet - All Other Plans | $1,352 - $1,353 | 1266% |
| Healthnet Comm Care | $1,395 - $1,396 | 1306% |
| Caremore Mcare - All Plans | $1,495 - $1,496 | 1400% |
| Hcpamg - All Plans | $1,498 - $1,499 | 1402% |
| Bella Vista Mcr Adv Op/Profee Only - All Other Pla | $1,600 | 1498% |
| Healthcare Inc - All Other Plans | $1,644 - $1,646 | 1539% |
| La Care Mcr Adv - All Plans | $1,644 - $1,646 | 1539% |
| First Heatlh Ppo - All Plans | $1,734 - $1,735 | 1623% |
| Phcs Ppo - All Plans | $1,944 - $1,945 | 1820% |
| Scan Health Mcare - All Plans | $1,944 - $1,945 | 1820% |
| Ahf - All Plans | $2,242 - $2,244 | 2099% |
| Beech Street - All Plans | $2,242 - $2,244 | 2099% |
| Interplan Ppo - All Plans | $2,242 - $2,244 | 2099% |
| Corvel Corp - All Plans | $2,392 - $2,394 | 2239% |
| Multiplan Ppo - All Plans | $2,482 - $2,483 | 2324% |
| Healthmannet - All Plans | $2,542 - $2,543 | 2380% |
| Next Inc Ppo - All Plans | $2,542 - $2,543 | 2380% |
| Trpn - All Plans | $2,542 - $2,543 | 2380% |
| Fpn Ppo - All Plans | $2,691 - $2,693 | 2519% |
| Healthnet Mcr Adv | $4,575 - $4,578 | 4283% |