CMS Price Transparency Data

Ultrasound, pelvis

Facility: John Muir Behavioral Health Center

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $705
  • Cash Discount Price: $721
  • vs. Medicare Baseline: 6.60x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at John Muir Behavioral Health Center is $705. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $721. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 6.60x the Medicare baseline. Located in 2740 Grant Street, Concord, CA.
Cash / Self-Pay
$721

Average discount available for prompt cash payment at this facility.

Insurance Median
$705

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: $721 (675%)
Insurance Median: $705 (660%)
Cash: $721 (675% of Medicare)
Ins. Median: $705 (660% 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 660% of the Medicare baseline (a markup of 560%). 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.

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
Alignment Health [1177113] $148 139%
Blue Cross Blue Shield $148 - $962 139%
Care 1St Health Plan [1094113] $148 139%
Caremore [1171113] $148 139%
Essence Healthcare [1049128] $148 139%
Medicare (plans) $148 - $154 139%
Aetna $154 - $962 144%
Blue Shield-Network Mcare [1006127] $154 144%
Easy Choice Health Plan [1083113] $154 144%
Golden State-Network Mcare [1023127] $154 144%
Humana $154 - $705 144%
Scan-Network Mcare [1043127] $154 144%
UnitedHealthcare $154 144%
Veterans Administration [1051113] $154 144%
Workers' Comp [1024005] $177 166%
Generic Commercial/Indemnity [1017001] $185 - $1,186 173%
Generic Hmo [1018103] $185 173%
Generic Ppo [1021104] $185 173%
Contra Costa County Jail [1012104] $705 660%
Federal Correction Institute [1062104] $705 660%
Fortified Provider Network [1063104] $705 660%
Galaxy Health Network [1064104] $705 660%
Health Management Network [1066104] $705 660%
Healthsmart - Pka Interplan [1031104] $705 660%
Hospice Of East Bay [1085104] $705 660%
Integrated Health Plan [1075104] $705 660%
Medigap [1036001] $705 660%
National Provider Network/Plancare America [1069104] $705 660%
Networks By Design [1084104] $705 660%
Pponext [1072104] $705 660%
Sutter Preferred Health Plan [1044104] $705 660%
Three Rivers Provider Network [1073104] $705 660%
Blue Shield Hmo [1006103] $771 722%
Blue Shield Ppo [1006104] $771 722%
Blue Shield-Network [1006026] $771 722%
Carelon Behavioral Health [1050104] $882 826%
Health Net Hmo [1028103] $882 826%
Health Net Ppo [1028104] $882 826%
Health Net-Network [1028026] $882 826%
Aps Healthcare [1003103] $962 901%
Brms [1091104] $962 901%
Delta Health Systems [1032104] $962 901%
Empire Plan [1092104] $962 901%
Healthcomp [1089104] $962 901%
Kaiser Hmo [1033103] $962 901%
Carecentrix [1011001] $1,186 1110%
Donor Network West [1008103] $1,186 1110%
Western Health Advantage Hmo [1053103] $1,186 1110%
Cigna $1,202 1125%
Beacon Health Strategies [1005103] $1,283 1201%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2740 Grant Street, Concord, CA 94520
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Psychiatric