CMS Price Transparency Data

Ultrasound, pelvis

Facility: Bristol Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $139
Cash Discount Price: $598
vs. Medicare Baseline: 1.30x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Bristol Hospital is $139. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $598. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.30x the Medicare baseline. Located in 41 Brewster Rd, Bristol, CT.

Cash / Self-Pay

$598

Average discount available for prompt cash payment at this facility.

Insurance Median

$139

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: $598 (560%)

Insurance Median: $139 (130%)

Cash: $598 (560% of Medicare)

Ins. Median: $139 (130% 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
Aetna	$109 - $221	102%
Blue Cross Blue Shield	$109 - $144	102%
Connecticare	$109 - $280	102%
UnitedHealthcare	$109 - $179	102%
Wellcare	$109 - $131	102%
Carepartners of Ct	$115 - $133	108%
Claim Doc	$219 - $254	205%
Cigna	$310	290%
Multiplan	$813 - $949	761%

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 $598.
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 Bristol Hospital 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.