CMS Price Transparency Data
Ultrasound, pelvis
Facility: Menifee Global Medical Center
Billing Code: 76856 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 76856
- Insurance Median: $201
- Cash Discount Price: $999
- vs. Medicare Baseline: 1.88x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Menifee Global Medical Center is $201. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $999. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.88x the Medicare baseline. Located in 28400 McCall Boulevard, Sun City, CA.
Cash / Self-Pay
$999
Average discount available for prompt cash payment at this facility.
Insurance Median
$201
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: $999 (935%)
Insurance Median: $201 (188%)
Cash: $999 (935% of Medicare)
Ins. Median: $201 (188% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Lasalle Medical Assoc (Ancillary) Mcal Hmo | $80 | 75% |
| Tricare | $96 - $125 | 90% |
| Health Net Medi-Cal | $97 | 91% |
| Hpn Mcal | $97 | 91% |
| Ic | $97 - $1,370 | 91% |
| Kaiser Medi-Cal | $97 | 91% |
| Prospect Health Plan Mcal Hmo | $100 | 94% |
| Blue Cross Blue Shield | $102 | 95% |
| Molina Medi-Cal | $115 | 108% |
| Aetna | $134 - $748 | 125% |
| Altamed Comm Hmo (Ancillary) | $134 - $1,370 | 125% |
| Altamed Health Services Senior | $134 | 125% |
| Altamed Sr/Pace | $134 | 125% |
| Blue Shield Senior | $134 | 125% |
| Central Health Plan Senior | $134 | 125% |
| Clever Care Health Plan Sr | $134 | 125% |
| For Your Benefit Senior | $134 | 125% |
| Guidant Health Plan Senior | $134 | 125% |
| Health Net Senior | $134 | 125% |
| Hpn Senior | $134 | 125% |
| Humana | $134 | 125% |
| Imperial Health Plan Of Ca | $134 | 125% |
| Kaiser Senior | $134 | 125% |
| Lasalle Medical Assoc (Ancillary) Commercial | $134 | 125% |
| Lasalle Medical Assoc (Ancillary) Senior | $134 | 125% |
| Managed Health Network Sr | $134 | 125% |
| Medicare (plans) | $134 | 125% |
| Neighborhood Healthcare Pace | $134 | 125% |
| Point Comfort Underwriters | $134 | 125% |
| Primecare Senior | $134 | 125% |
| Prospect Health Plan Sr Hmo | $134 | 125% |
| Scan Senior | $134 | 125% |
| Self Pay/Ab774/Charity Discount | $134 | 125% |
| Sr Capitation | $134 | 125% |
| UnitedHealthcare | $134 - $279 | 125% |
| Veterans Administration | $134 | 125% |
| Altamed Mcal Hmo | $136 | 127% |
| Altamed Mcal/Pace | $136 | 127% |
| Choice Physicians Network | $136 | 127% |
| Iehp Medi-Cal | $146 | 137% |
| Align Senior Care | $150 | 140% |
| Welbehealth Sr/Pace | $150 | 140% |
| Cigna | $152 - $1,096 | 142% |
| Prime Health Services Senior | $154 | 144% |
| Health Net Enhanced Ppo | $158 - $187 | 148% |
| Molina Covered Ca | $159 | 149% |
| Coventry | $161 - $167 | 151% |
| Prime Health Services Wcomp | $161 | 151% |
| Iehp Covered Ca | $167 | 156% |
| Three Rivers Wcomp | $175 | 164% |
| Workers Comp Non-Contracted | $179 | 168% |
| Prospect Health Plan Comm Hmo | $181 | 169% |
| Hpn Commercial/Covered Ca | $187 | 175% |
| Health Net Comm | $201 | 188% |
| Three Rivers Network | $235 | 220% |
| Velocity | $235 - $616 | 220% |
| First Health Commercial | $329 - $719 | 308% |
| Blue Shield Epn | $376 | 352% |
| Primecare Commercial | $408 - $890 | 382% |
| Multiplan Ppo | $439 - $959 | 411% |
| Multiplan Wcomp | $439 - $959 | 411% |
| Blue Shield Commercial | $443 | 415% |
| Pnoa-Provider Network Of America | $502 - $1,096 | 470% |
| Prime Health Services Commercial | $502 - $1,096 | 470% |
| Ava Hospice | $627 - $1,370 | 587% |
| Kaiser Commercial | $627 - $1,370 | 587% |
| Living Waters Hospice | $627 - $1,370 | 587% |
| Managed Health Network | $627 - $1,370 | 587% |
| Other Insurance Loa | $627 - $1,370 | 587% |
| Pacific Valley Hospice | $627 - $1,370 | 587% |
| Private Pay | $627 - $1,370 | 587% |
| Silverado Hospice | $627 - $1,370 | 587% |
| Vna Hospice | $627 - $1,370 | 587% |