CMS Price Transparency Data

Ultrasound, pelvis

Facility: Greater El Monte Community Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $402
  • Cash Discount Price: $1,112
  • vs. Medicare Baseline: 3.76x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Greater El Monte Community Hospital is $402. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,112. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.76x the Medicare baseline. Located in 1701 Santa Anita Ave, South El Monte, CA.
Cash / Self-Pay
$1,112

Average discount available for prompt cash payment at this facility.

Insurance Median
$402

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: $1,112 (1041%)
Insurance Median: $402 (376%)
Cash: $1,112 (1041% of Medicare)
Ins. Median: $402 (376% 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 376% of the Medicare baseline (a markup of 276%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

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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
In Custody-Ca Highway Patrol $20 19%
Blue Cross Blue Shield $21 - $596 20%
Aids Health Foundation $68 - $132 64%
Allied Physicians Medical Group $68 - $358 64%
Altamed Health Network $68 - $132 64%
Avanti $68 - $161 64%
Beverly Hospital $68 - $148 64%
Brand New Day $68 - $168 64%
Emanate Health $68 - $168 64%
Health Net Foundation $68 - $775 64%
Healthy Way La $68 64%
La Care Health Plan $68 - $656 64%
Other Non Contracted Medi-Cal Hmo $68 64%
State Of California $68 64%
Care 1St Medi Cal Hmo Cap Exceptional Care $85 - $119 80%
Care First Health Plan $85 - $119 80%
Veterans Administration $94 88%
Allied Physicians $97 - $198 91%
Associated Hispanic Physicians $97 - $121 91%
Hollywood Presbyterian Adv Med Mcal $97 91%
Hollywood Presbyterian Medpoint Mcal $97 91%
Caloptima $99 93%
Clinica Medica Familiar $102 - $596 95%
Apa/Aco Inc $132 124%
Blue Shield Of California $132 - $649 124%
Cms $132 124%
Easy Choice Health Plan $132 124%
Health Net Inc $132 - $844 124%
Other Non Contracted Senior Hmo $132 124%
Pacific Alliance Medical Center Reciprocal Contract $132 124%
Scan Health Plan $132 124%
UnitedHealthcare $132 - $1,023 124%
Champus Foundation $134 125%
Cv-19 Hrsa Uninsured Testing And Tx I/P And O/P $134 125%
Good Samaritan Medical Practice Assoc $134 - $715 125%
La Care Covered Direct $134 125%
Pacificare Of California $134 - $1,032 125%
Self-Pay $134 125%
Alignment Health Plan $139 130%
Molina Healthcare $139 130%
Inter Valley Health Plan $141 132%
Molina Healthcare Of California $141 - $465 132%
San Miguel Health Plan $148 139%
Chinatown Service Center Pace $159 149%
Intercomp $161 151%
Ahmc Health Self-Insurance Epo $168 157%
Knox-Keene Act $168 157%
Bella Vista Medical Group Ipa $170 - $536 159%
Employee Health Systems Medical Group $170 - $238 159%
Global Care Medical Group Ipa $170 - $536 159%
Preferred Health Network $170 159%
Interplan $173 - $894 162%
Central Health Plan $174 - $834 163%
Athens Administrators $179 168%
Multiplan $179 - $1,013 168%
Other Non Contracted Work Comp $179 168%
Alta Med Health Services Med Grp $213 - $298 199%
Cigna $241 226%
Ahmc Reciprocity Agreement $255 - $358 239%
Ahmc Reciprocity Agreement Senior/Commercial $255 - $358 239%
Lincoln Hospital Medical Center $255 - $358 239%
California Thoroughbred Horesmans Foundation $426 - $596 399%
Universal Care $426 - $834 399%
Care 1St Health Plan $511 - $715 478%
Cost Containment Strategies $553 - $775 518%
In Custody Police Dept $553 - $775 518%
Community Care Network $681 - $954 638%
Health Payors Organization $766 - $1,073 717%
Commercial Non Contract $851 - $1,192 797%
Medi-Cal Sub Acute $851 - $1,192 797%
Nuclear Medicine/Whmc $851 - $1,192 797%
One Legacy $851 - $1,192 797%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1701 Santa Anita Ave, South El Monte, CA 91733
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals