CMS Price Transparency Data

Ultrasound, pelvis

Facility: Adventist Health Howard Memorial

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $102
Cash Discount Price: $130
vs. Medicare Baseline: 0.95x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Adventist Health Howard Memorial is $102. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $130. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.95x the Medicare baseline. Located in 1 Marcela Dr, Willits, CA.

Cash / Self-Pay

$130

Average discount available for prompt cash payment at this facility.

Insurance Median

$102

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: $130 (122%)

Insurance Median: $102 (95%)

Cash: $130 (122% of Medicare)

Ins. Median: $102 (95% 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.

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
Blue Shield Mcare	$26 - $287	24%
Medicare (plans)	$26 - $289	24%
Tricare	$26 - $287	24%
UnitedHealthcare	$28 - $1,109	26%
Ah Employee Health Plan - All Plans	$36 - $745	34%
Cigna	$40 - $1,218	37%
Blue Shield - All Other Plans	$43 - $982	40%
Healthnet - All Plans	$48 - $1,175	45%
Western Growers/Pinnacle - All Plans	$50 - $1,075	47%
Medi-Cal	$68 - $97	64%
Aetna	$83 - $961	78%
Blue Shield Epn	$88 - $980	82%
First Health Ppo - All Plans	$102 - $1,146	95%
Ghn Ppo - All Plans	$102 - $1,146	95%
Brms - All Plans	$109 - $1,218	102%
Blue Cross Blue Shield	$437 - $524	409%

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 $130.
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 Adventist Health Howard Memorial 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.