CMS Price Transparency Data

Ultrasound, pelvis

Facility: Adventist Health Lodi Memorial

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $130
  • Cash Discount Price: $72
  • vs. Medicare Baseline: 1.22x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Adventist Health Lodi Memorial is $130. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $72. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.22x the Medicare baseline. Located in 975 S Fairmont Avenue, Lodi, CA.
Cash / Self-Pay
$72

Average discount available for prompt cash payment at this facility.

Insurance Median
$130

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: $72 (67%)
Insurance Median: $130 (122%)
Cash: $72 (67% of Medicare)
Ins. Median: $130 (122% 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
Alignment Health Plan (Ahp)-All Plans $33 - $138 31%
Blue Shield Mcare Adv $33 - $138 31%
Healthnet Mcare $33 - $138 31%
Hp Of San Joaquin Mcr Adv $33 - $138 31%
Humana $33 - $138 31%
Knnex Health - All Plans $33 - $165 31%
Medcore(Omni Ipa) Op Only- All Plans $33 - $921 31%
Tricare $33 - $138 31%
UnitedHealthcare $33 - $1,471 31%
Hp Healthy Kids Pro Fee $35 33%
Ah Employee Health Plan - All Plans $36 - $248 34%
Blue Shield Epn - All Other Plans $40 - $1,148 37%
Cigna $40 - $3,190 37%
First Health- All Plans $40 - $2,906 37%
Beech Street- All Plans $43 - $3,190 40%
Blue Shield Non-Epn $43 - $1,191 40%
Hp Of San Joaquin Ppo - All Other Plans $43 - $3,367 40%
Multiplan- All Plans $43 - $2,835 40%
Kaiser Commercial - All Other Plans $45 - $1,453 42%
Kaiser Mcr Adv $45 - $138 42%
Networks By Design- All Plans $45 - $1,772 42%
Healthnet- All Other Plans $48 - $1,740 45%
Western Growers- All Plans $50 - $3,190 47%
Bc Mcal $53 - $68 50%
Blue Cross Blue Shield $61 - $483 57%
Celtic Ins Company - All Plans $68 - $109 64%
Kaiser Mcal $68 - $97 64%
Medi-Cal $68 - $97 64%
Hp Mcal Pro Fee $74 69%
Healthnet Mcal $81 - $139 76%
Hp Of San Joaquin Mcal $81 - $121 76%
Three Rivers Provider Network- All Plans $115 - $3,190 108%
Aetna $132 - $1,085 124%
Cca Health Plan Mcr Adv- All Plans $138 129%
Bright Health - All Plans $276 258%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 975 S Fairmont Avenue, Lodi, CA 95240
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals