CMS Price Transparency Data
Ultrasound, pelvis
Facility: Coastal Communities Hospital
Billing Code: 76856 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 76856
- Insurance Median: $154
- Cash Discount Price: $1,161
- vs. Medicare Baseline: 1.44x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Coastal Communities Hospital is $154. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,161. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.44x the Medicare baseline. Located in 2701 S Bristol St, Santa Ana, CA.
Cash / Self-Pay
$1,161
Average discount available for prompt cash payment at this facility.
Insurance Median
$154
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: $1,161 (1087%)
Insurance Median: $154 (144%)
Cash: $1,161 (1087% of Medicare)
Ins. Median: $154 (144% 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 |
|---|---|---|
| Kpc Healthcare Inc | $81 - $168 | 76% |
| Altamed Mcal Hmo (Ancillary) | $97 | 91% |
| Healthcare Partners | $97 | 91% |
| Hollywood Presbyterian | $97 - $134 | 91% |
| Kaiser | $97 - $715 | 91% |
| Medi-Cal Hmo/Non Contract | $97 | 91% |
| Medicaid / KanCare | $97 | 91% |
| Monarch | $114 - $135 | 107% |
| Altamed Health Services | $127 - $136 | 119% |
| Champus | $129 | 121% |
| Blue Shield | $134 - $510 | 125% |
| Caloptima | $134 - $136 | 125% |
| Central Health Plan Of California | $134 | 125% |
| Champion Health Plan | $134 | 125% |
| Choice Physicians Network | $134 | 125% |
| Citizens Choice Health Plan | $134 | 125% |
| Clever Care Health Plan | $134 | 125% |
| Easy Choice Health Plan | $134 | 125% |
| For Your Benefit | $134 | 125% |
| Health Net | $134 - $848 | 125% |
| Healthcare Partners Sr Hmo | $134 | 125% |
| Heritage | $134 | 125% |
| Humana | $134 | 125% |
| Imperial Health Plan Of Ca | $134 | 125% |
| Innovative Integrated Health | $134 | 125% |
| Medcare Partners | $134 | 125% |
| Onecare | $134 | 125% |
| Onecare Connect | $134 | 125% |
| Other Senior Non Contract | $134 | 125% |
| Prospect Health Plan | $134 - $202 | 125% |
| Scan Health Plan | $134 | 125% |
| Self Pay Ab774/Cbo Use Only | $134 | 125% |
| UnitedHealthcare | $134 - $154 | 125% |
| Us Dept Of Labor | $134 | 125% |
| Us Federal Marshall/Department Of Immigration | $134 | 125% |
| Velocity Provider Network Sr | $134 | 125% |
| Verda Health Plan Sr | $134 | 125% |
| Veterans Administration | $134 | 125% |
| Victim Of Violent Crime | $134 | 125% |
| Victoria Hospice | $134 | 125% |
| Choc Health Alliance | $136 | 127% |
| County Of Orange | $136 | 127% |
| Family Choice | $136 | 127% |
| Heritage Provider Network | $136 - $697 | 127% |
| Monarch Health Plan | $144 | 135% |
| Brand New Day | $150 | 140% |
| Prime Health Srvs | $154 - $929 | 144% |
| Cigna | $155 - $755 | 145% |
| Coventry Auto Network | $161 | 151% |
| Prime Health Srvs/Wc | $161 | 151% |
| Interplan | $163 - $871 | 153% |
| County Of Orange/Custody/Advanced Medmgt | $167 | 156% |
| Coventry Wc | $167 | 156% |
| Veterans Evaluation Services | $168 | 157% |
| Multiplan | $175 - $813 | 164% |
| Three Rivers | $175 | 164% |
| Velocity National Provider Network Wc | $179 | 168% |
| Workers Comp State Of California | $179 | 168% |
| Staywell/Island Home Ins | $188 | 176% |
| Three Rivers Network | $235 | 220% |
| Velocity National Provider Network Ppo | $235 | 220% |
| Aetna | $258 | 242% |
| Ihhi Reciprocity | $270 | 253% |
| First Health | $610 | 571% |
| Magellan | $697 | 653% |
| Networks By Design | $813 | 761% |
| Networks By Design Wc | $813 | 761% |
| Healthsmart | $871 | 815% |
| Prime Health | $871 | 815% |
| Pnoa-Provider Network Of America | $929 | 870% |
| Prime Health Srvs/Network | $987 | 924% |
| Lucet Behavioral Health Sr | $1,161 | 1087% |
| Managed Health Network | $1,161 | 1087% |
| Other Insurance Loa | $1,161 | 1087% |
| Other Non Contracted Plans | $1,161 | 1087% |
| Private Pay | $1,161 | 1087% |
| Us Behavioral Health Plan | $1,161 | 1087% |
| Vitas Hospice | $1,161 | 1087% |