CMS Price Transparency Data

Ultrasound, pelvis

Facility: AHMC Anaheim Regional Medical Center

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $134
  • Cash Discount Price: $1,875
  • vs. Medicare Baseline: 1.25x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at AHMC Anaheim Regional Medical Center is $134. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,875. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.25x the Medicare baseline. Located in 1111 W La Palma Avenue, Anaheim, CA.
Cash / Self-Pay
$1,875

Average discount available for prompt cash payment at this facility.

Insurance Median
$134

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: $1,875 (1755%)
Insurance Median: $134 (125%)
Cash: $1,875 (1755% of Medicare)
Ins. Median: $134 (125% 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.

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
Private Pay Flat Rate $40 37%
Msi/Medical Services For Indigents $52 49%
Ahmc Reciprocity Agreement $68 - $562 64%
Allied Physicians $68 - $202 64%
Altamed Health Network $68 - $132 64%
Applecare Medical Group $68 64%
Beverly Hospital $68 - $148 64%
Brand New Day $68 - $168 64%
Health Net $68 64%
Healthcare Partners $68 - $132 64%
Healthy Way La $68 64%
Heritage Provider Network $68 - $182 64%
Non Contracted Medi-Cal $68 64%
Talbert Medical Group $68 - $92 64%
Affiliated Doctors Of Orange County $70 66%
Memorial Healthcare Ipa $74 69%
Monarch Healthcare Medical Group $86 81%
Veterans Administration $94 88%
Caloptima $95 - $132 89%
Monarch Health Plan $95 - $1,273 89%
Prospect Health Plan $95 - $182 89%
Aids Health Foundation $97 - $132 91%
Avanti $97 - $161 91%
Emanate Health $97 - $168 91%
Health Net Inc $97 - $1,440 91%
Healthnet Cal Optima Medi-Cal/Healthy Families $97 91%
Hollywood Presbyterian Advanced Med Mgmt Mcal $97 91%
Hollywood Presbyterian Medpoint Mcal $97 91%
Kaiser Foundation Hospitals $97 - $132 91%
Medi-Cal $97 91%
Medical Safety Net Program $97 91%
Prospect Medical Group $121 113%
Alta Los Angeles Hospital $126 118%
Tricare $128 120%
Aetna $132 - $278 124%
Alignment Health Plan $132 124%
Apa Aco Inc $132 124%
Blue Cross Blue Shield $132 - $238 124%
Blue Shield Of California $132 - $715 124%
California Health Plan $132 124%
Central Health Of California $132 124%
Davita Heatlhcare Partners Plan Inc $132 - $1,012 124%
Healthnet $132 124%
Humana $132 124%
Medicare (plans) $132 - $938 124%
Pacificare $132 124%
Scan Health Plan $132 124%
Seoul Medical Group $132 - $134 124%
Wellcare $132 124%
Cv-19 Hrsa Uninsured Testing And Tx I/P And O/P $134 125%
Innovative Integrated Health (Iih)/Orange County Pace $134 125%
Memorial Healthcare Ipa/Cap/Valuation Rates $134 125%
Self-Pay $134 125%
Nchp $139 130%
Align Senior Care $140 131%
Angels Baseball Workers Comp $152 142%
Interplan $161 - $1,312 151%
Ahmc Health Self-Insurance Epo $168 157%
Knox-Keene Act $168 157%
First Health $173 - $1,594 162%
Orange County Preferred Provider Organization $173 - $1,406 162%
UnitedHealthcare $178 - $445 167%
Athens Administrators $179 168%
Capp Care $179 - $1,406 168%
Cigna $179 - $241 168%
Corvel $179 - $1,406 168%
Marriot Intl $179 168%
Non Contracted Workers Comp $179 168%
Netcare Life And Health Insurance $469 439%
Advance Clinical Research Institute $562 526%
Medical Acquisition Company $750 702%
Healthcare Partners Commercial $1,012 947%
Huntington Memorial Hospital $1,012 947%
Genesis Healthcare Ipa Ancillary $1,125 1053%
Affiliated Health Fund $1,312 1228%
Allnet Preferred Provider $1,312 1228%
Care First $1,312 1228%
Private Healthcare Systems $1,312 1228%
Choicecare $1,406 1316%
Multiplan Inc $1,406 1316%
National Provider Network $1,500 1404%
Three Rivers Providers Network $1,500 1404%
Health Payors Organization $1,688 1580%
Non Contracted Commercial $1,875 1755%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1111 W La Palma Avenue, Anaheim, CA 92801
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals