CMS Price Transparency Data

Ultrasound, pelvis

Facility: Adventist Health Ukiah Valley

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $238
Cash Discount Price: $73
vs. Medicare Baseline: 2.23x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Adventist Health Ukiah Valley is $238. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $73. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.23x the Medicare baseline. Located in 275 Hospital Drive, Ukiah, CA.

Cash / Self-Pay

$73

Average discount available for prompt cash payment at this facility.

Insurance Median

$238

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: $73 (68%)

Insurance Median: $238 (223%)

Cash: $73 (68% of Medicare)

Ins. Median: $238 (223% 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 223% of the Medicare baseline (a markup of 123%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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 Shield Mcr Adv	$33 - $144	31%
Kaiser Mcr Adv	$33 - $144	31%
Tricare	$33 - $144	31%
Ah Employee Health Plan - All Plans	$36 - $259	34%
Blue Shield Epn-All Other Plans	$40 - $569	37%
Cigna	$42 - $1,165	39%
Blue Shield Non-Epn	$43 - $576	40%
UnitedHealthcare	$43 - $1,248	40%
Healthnet-All Plans	$48 - $854	45%
Western Growers-All Plans	$49 - $627	46%
Kaiser Medi-Cal	$68 - $97	64%
Medi-Cal	$68 - $97	64%
Aetna	$83 - $627	78%
Mendocino Lcc District-All Plans	$83 - $970	78%
Kaiser-All Other Plans	$102 - $1,194	95%
Three Rivers-All Plans	$115 - $1,344	108%
Foundation For Medical Care-All Plans	$223 - $1,120	209%
Networks By Design-All Plans	$238 - $1,194	223%
Phcs Multiplan-All Plans	$238 - $1,194	223%
Interplan-All Plans	$244 - $1,224	228%
Beech Street-All Plans	$252 - $1,269	236%
Choice Care-All Plans	$252 - $1,269	236%
Health Mgmt Network-All Plans	$252 - $1,269	236%
Blue Cross Blue Shield	$444 - $592	416%

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 $73.
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 Adventist Health Ukiah Valley 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.