CMS Price Transparency Data

Ultrasound, pelvis

Facility: UCSF Health St. Mary's Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $156
Cash Discount Price: $1,938
vs. Medicare Baseline: 1.46x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at UCSF Health St. Mary's Hospital is $156. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,938. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.46x the Medicare baseline. Located in 450 Stanyan St, San Francisco, CA.

Cash / Self-Pay

$1,938

Average discount available for prompt cash payment at this facility.

Insurance Median

$156

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: $1,938 (1814%)

Insurance Median: $156 (146%)

Cash: $1,938 (1814% of Medicare)

Ins. Median: $156 (146% 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.

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
Sfhp	$95	89%
California Health & Wellness	$97	91%
Health Plan San Mateo	$97 - $156	91%
Kaiser	$97 - $1,151	91%
Partnership Health Plan	$97	91%
Blue Cross Blue Shield	$120 - $1,120	112%
Brown Toland	$142 - $156	133%
Health Net	$142 - $156	133%
Aetna	$156 - $706	146%
Blue Shield Ca	$156	146%
Chinese Community	$156 - $984	146%
Connected Care	$156	146%
Humana	$156	146%
Mhn	$156	146%
United	$156 - $245	146%
Kentfield	$453	424%
Oscar	$512	479%
Cigna	$863 - $919	808%
Magellan	$908 - $1,417	850%
Healthsmart	$1,060 - $1,653	992%
Multiplan	$1,257 - $1,960	1177%
Us Behavioral Health	$1,514	1417%

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 $1,938.
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 UCSF Health St. Mary's Hospital 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.