CMS Price Transparency Data

Ultrasound, pelvis

Facility: Children's Hospital Colorado

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $785
  • Cash Discount Price: $774
  • vs. Medicare Baseline: 7.35x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Children's Hospital Colorado is $785. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $774. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 7.35x the Medicare baseline. Located in 13123 E 16Th Ave, Aurora, CO.
Cash / Self-Pay
$774

Average discount available for prompt cash payment at this facility.

Insurance Median
$785

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: $774 (725%)
Insurance Median: $785 (735%)
Cash: $774 (725% of Medicare)
Ins. Median: $785 (735% 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 735% of the Medicare baseline (a markup of 635%). 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
Denver Health Medical Plan $46 - $892 43%
Ccha Behavioral Health $119 111%
Integrated Health Plan $178 167%
Kaiser $405 - $869 379%
Rocky Mountain Health Plan Behavioral Health $476 446%
Carelon Behavioral Health $536 - $833 502%
Presbyterian Health Plan $571 - $678 535%
Colorado Access $583 546%
Colorado Access Behavioral Health $583 546%
Molina Healthcare Of Nebraska $654 612%
Molina Healthcare Of New Mexico $654 612%
Peak Health Alliance/Ebms $654 - $714 612%
Rocky Mountain Health Plan $654 - $774 612%
Healthy Blue Of Nebraska $690 646%
Humana $726 - $833 680%
UnitedHealthcare $741 - $797 694%
Evernorth Behavioral Health $774 725%
Interlink National $774 - $892 725%
Blue Cross Blue Shield $797 - $892 746%
Centivo $821 769%
Select Health $833 780%
Uchealth Plan Administrators $833 780%
Cigna $859 804%
Aetna $869 - $952 814%
Department Of Corrections $928 869%
Comppsych Behavioral Health $1,012 947%
First Choice Health $1,012 947%
Midlands Choice $1,012 947%
National Preferred Provider Network $1,012 947%
Multiplan $1,023 958%
Cofinity $1,071 1003%
First Choice Of The Midwest $1,071 1003%
Usa Managed Care Organization $1,071 1003%
First Health Network $1,095 1025%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 13123 E 16Th Ave, Aurora, CO 80045
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens