CMS Price Transparency Data
Ultrasound, pelvis
Facility: Whittier Hospital Medical Center
Billing Code: 76856 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 76856
- Insurance Median: $168
- Cash Discount Price: $248
- vs. Medicare Baseline: 1.57x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Whittier Hospital Medical Center is $168. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $248. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.57x the Medicare baseline. Located in 9080 Colima Rd, Whittier, CA.
Cash / Self-Pay
$248
Average discount available for prompt cash payment at this facility.
Insurance Median
$168
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: $248 (232%)
Insurance Median: $168 (157%)
Cash: $248 (232% of Medicare)
Ins. Median: $168 (157% 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 |
|---|---|---|
| Blue Cross Blue Shield | $19 - $920 | 18% |
| Ahmc Medi-Cal Reciprocity Agreement | $68 | 64% |
| Aids Healthcare Foundation | $68 - $132 | 64% |
| Allied Physicians | $68 - $202 | 64% |
| Alta Med Health Network | $68 - $132 | 64% |
| Altamed Health Services Corporation | $68 | 64% |
| Beverly Hospital | $68 - $148 | 64% |
| Brand New Day | $68 - $165 | 64% |
| Emanate Health | $68 - $165 | 64% |
| Health Net | $68 - $1,100 | 64% |
| Healthy Way La | $68 | 64% |
| Heritage Provider Network | $68 - $182 | 64% |
| Kaiser Foundation | $68 - $1,288 | 64% |
| La Care Healthy Families/Healthy Kids | $68 | 64% |
| Non Contracted Medi-Cal | $68 | 64% |
| Prospect Health Plan | $68 - $215 | 64% |
| Synermed | $68 - $134 | 64% |
| Capnet | $74 | 69% |
| Alliance Imaging | $75 | 70% |
| La Care Health Plan | $78 - $1,012 | 73% |
| Veterans Administration | $94 | 88% |
| Caloptima | $95 - $132 | 89% |
| Monarch Healthplan | $95 | 89% |
| Avanti | $97 - $161 | 91% |
| Care First Health Plan | $97 | 91% |
| County Of Los Angeles Dept Of Health Services | $97 | 91% |
| Hollywood Presbyterian Adv Med Mcal | $97 | 91% |
| Hollywood Presbyterian Medpoint Mcal | $97 | 91% |
| Medi Caid/ Medi Cal | $97 | 91% |
| Pacific Independent Physician Association | $97 - $552 | 91% |
| Applecare Medical Group | $103 | 96% |
| Aetna | $132 - $1,340 | 124% |
| Alta Los Angeles Hospitals Inc | $132 | 124% |
| Apa/Aco Inc | $132 | 124% |
| Central Health Plan | $132 | 124% |
| Easy Choice Health Plan | $132 | 124% |
| Humana | $132 | 124% |
| Medicare (plans) | $132 - $139 | 124% |
| Pacificare Of California | $132 | 124% |
| Scan Health Plan | $132 | 124% |
| Blue Shield Of California | $134 - $920 | 125% |
| Caremore | $134 | 125% |
| Cov19 Hrsa Uninsured Testing And Treatment Fund | $134 | 125% |
| La Care Covered Direct | $134 | 125% |
| Pacific Alliance Medical Center | $134 | 125% |
| Private Pay | $134 | 125% |
| Self-Pay | $134 | 125% |
| Tricare | $134 | 125% |
| Alignment Health Plan | $139 | 130% |
| Molina Healthcare Of California | $139 | 130% |
| San Miguel Health Plan | $148 | 139% |
| Chinatown Service Center Pace | $161 | 151% |
| Ahmc Health | $168 | 157% |
| Knox-Keene Act | $168 | 157% |
| Molina Medical Center | $168 - $718 | 157% |
| Fmc Los Angeles County | $170 - $1,380 | 159% |
| Interplan Health Group | $173 | 162% |
| UnitedHealthcare | $178 - $1,601 | 167% |
| Athens Administrators Ahmc Work Comp | $179 | 168% |
| Misc 1 | $179 | 168% |
| Multiplan Wc | $179 | 168% |
| Physician Healthways | $184 | 172% |
| Cigna | $241 | 226% |
| Davita Healthcare Partners | $287 | 269% |
| Health Net Inc | $330 - $1,196 | 309% |
| Healthnet | $404 - $1,277 | 378% |
| Physicians Healthways Medical Corporation | $460 | 431% |
| Ahmc Reciprocity | $552 | 517% |
| Ahmc Reciprocity Agreement Senior/Commercial | $552 | 517% |
| Wear And Wood | $552 - $736 | 517% |
| Edward Medical Group | $644 | 603% |
| Central Health Plan Of California | $736 | 689% |
| Allied Physicians Ipa | $828 | 775% |
| Prospect Medical | $1,012 | 947% |
| Care 1St Health Plan | $1,104 | 1034% |
| New Horizon Medical Group Inc | $1,104 | 1034% |
| Cost Containment | $1,196 | 1120% |
| Universal Care | $1,196 - $1,288 | 1120% |
| Asi/Flex | $1,288 | 1206% |
| Us Comp Care | $1,288 | 1206% |
| Value Healthplan Of California | $1,288 | 1206% |
| Community Care Network | $1,380 | 1292% |
| Coventry Health Care | $1,380 | 1292% |
| Coventry Health Care National Network | $1,380 | 1292% |
| Interplan Corporation | $1,380 | 1292% |
| Managed Care Administrators | $1,380 | 1292% |
| Prohealth | $1,380 | 1292% |
| Multiplan | $1,564 | 1464% |
| Commercial Non Contract | $1,840 | 1723% |
| Medi-Cal Sub Acute | $1,840 | 1723% |
| One Legacy | $1,840 | 1723% |
| Great-West Healthcare Of California | $2,500 | 2341% |