CMS Price Transparency Data

Ultrasound, pelvis

Facility: AHMC Seton Medical Center

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $190
  • Cash Discount Price: $1,593
  • vs. Medicare Baseline: 1.78x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at AHMC Seton Medical Center is $190. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,593. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.78x the Medicare baseline. Located in 1900 Sullivan Avenue, Daly City, CA.
Cash / Self-Pay
$1,593

Average discount available for prompt cash payment at this facility.

Insurance Median
$190

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: $1,593 (1491%)
Insurance Median: $190 (178%)
Cash: $1,593 (1491% of Medicare)
Ins. Median: $190 (178% 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
Blue Cross Blue Shield $21 - $1,512 20%
Medi-Cal $68 64%
San Mateo County/San Mateo County General Hospital $83 78%
Health Plan Of San Mateo Healthworx $84 79%
Health Plan Of San Mateo $95 89%
North East Medical Services $95 - $149 89%
San Francisco Health Plan $95 89%
Cmac $97 91%
Hill Physicians Medical Group Inc $97 - $119 91%
Kaiser $97 - $1,633 91%
Jade Health Care Mg $101 - $149 95%
Veterans Administration (Va) $106 99%
Asian American Medical Group $116 - $190 109%
Brown And Toland Medical Group $121 - $190 113%
Aetna $149 - $1,281 140%
Blue Shield Of California $149 - $832 140%
Brand New Day $149 - $190 140%
Care Advantage $149 140%
Chinese Community Health Plan $149 - $996 140%
For Your Benefit $149 140%
Healthnet Seniority $149 140%
Humana $149 140%
Imperial Health Plan $149 140%
Medicare (plans) $149 140%
Pacificare $149 140%
Tricare $151 141%
Apcmg $152 - $228 142%
Canopy Health $152 - $273 142%
Covid-19 Uninsured Program $152 142%
UnitedHealthcare $152 - $178 142%
Easy Choice Hospital Services $155 145%
Central Health Plan $161 151%
Ahmc Health $190 178%
Knox-Keene Act $190 178%
Athens Administrators $202 189%
Corvel Healthcare $202 189%
Multiplan/Bce Emergis $202 - $1,493 189%
Work Comp Other $202 189%
Workers Compensation Federal $268 251%
Self Pay $299 - $677 280%
Cigna $754 706%
Interplan Corporation $1,195 1119%
Private Healthcare Sytems Inc $1,493 1398%
The First Health Network $1,493 1398%
Health Net $1,527 1430%
Beech Street Corporation $1,593 1491%
Healthcare Foundation Of San Mateo $1,593 1491%
Choicecare Network $1,692 1584%
Multiplan $1,692 1584%
Mills Peninsula Health Services $1,792 1678%
Indemnity $1,991 1864%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1900 Sullivan Avenue, Daly City, CA 94015
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals