CMS Price Transparency Data

Ultrasound, pelvis

Facility: Boulder Community Health

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $107
  • Cash Discount Price: $943
  • vs. Medicare Baseline: 1.00x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Boulder Community Health is $107. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $943. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.00x the Medicare baseline. Located in 4747 Arapahoe Avenue, Boulder, CO.
Cash / Self-Pay
$943

Average discount available for prompt cash payment at this facility.

Insurance Median
$107

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: $943 (883%)
Insurance Median: $107 (100%)
Cash: $943 (883% of Medicare)
Ins. Median: $107 (100% 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
Cigna $16 - $2,966 15%
Medicare (plans) $24 - $1,409 22%
Select Health Colorado Public Option $24 - $1,409 22%
Select Health Value Network $24 - $1,409 22%
Devoted Health $26 - $1,483 24%
Aetna $32 - $3,229 30%
Blue Cross Blue Shield $32 - $2,208 30%
Health Spring $32 - $107 30%
Humana $32 - $108 30%
UnitedHealthcare $32 - $1,175 30%
Clear Spring $33 - $110 31%
Medicaid / KanCare $37 - $156 35%
Rocky Mountain Health Maintenance Organization $37 - $219 35%
Colorado Access $40 - $203 37%
Multiplan $44 - $2,596 41%
Phcs $44 - $2,596 41%
Rocky Mountain Health Maintenance Organization Private Plan $45 - $2,596 42%
Integrated Health Plans Bch $48 - $2,781 45%
Beech Street Community Medical Associates $49 - $166 46%
Kaiser Ppo $49 - $437 46%
Kaiser Public Option $49 - $366 46%
Casualty Management Network, Prime Health Services Behavioral Health $54 - $3,152 51%
Mines And Associates $54 - $3,152 51%
Three Rivers Provider Network $54 - $3,152 51%
Zelis (Profee) $54 - $3,152 51%
Casualty Management Network, Prime Health Services Community Medical Associates $58 - $3,337 54%
National Preferred Provider Network $58 - $3,337 54%
Rockport Healthcare Group Community Medical Associates $58 - $3,337 54%
Usa $58 - $3,337 54%
Rockport Healthcare Group Bch $60 - $3,448 56%
Health Management Network Bch Community Medical Associates $61 - $3,560 57%
Health Management Network Community Medical Associates $61 - $3,560 57%
Health Payors Organization $61 - $3,523 57%
National Provider Network $62 - $3,597 58%
Kaiser $435 407%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4747 Arapahoe Avenue, Boulder, CO 80304
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals