CMS Price Transparency Data

Ultrasound, pelvis

Facility: Loma Linda University Medical Center-Murrieta

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $231
Cash Discount Price: $831
vs. Medicare Baseline: 2.16x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Loma Linda University Medical Center-Murrieta is $231. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $831. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.16x the Medicare baseline. Located in 28062 Baxter Road, Murrieta, CA.

Cash / Self-Pay

$831

Average discount available for prompt cash payment at this facility.

Insurance Median

$231

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: $831 (778%)

Insurance Median: $231 (216%)

Cash: $831 (778% of Medicare)

Ins. Median: $231 (216% 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 216% of the Medicare baseline (a markup of 116%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Inland Empire Health Plan (Iehp)	$110 - $135	103%
Alpha Care Medical Group	$135 - $203	126%
Dignity Health	$135 - $203	126%
Epic Health Plan	$135 - $1,200	126%
Trivalley Medical Group	$135	126%
Vantage Medical Group	$135 - $203	126%
UnitedHealthcare	$154	144%
Kaiser Foundation Hospitals	$155 - $881	145%
Molina Healthcare Of Ca	$170	159%
Blue Shield Of California	$259 - $322	242%
Adventist Health	$369	345%
Lluh Dept Of Risk Management	$462	433%
Aetna	$987 - $1,268	924%
Heritage Provider Network	$1,143 - $1,250	1070%
Cigna	$1,200	1123%
Multiplan	$1,384	1296%

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 $831.
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 Loma Linda University Medical Center-Murrieta 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.