CMS Price Transparency Data

Ultrasound, pelvis

Facility: Children's Healthcare of Atlanta at Scottish Rite

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $844
Cash Discount Price: $1,232
vs. Medicare Baseline: 7.90x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Children's Healthcare of Atlanta at Scottish Rite is $844. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,232. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 7.90x the Medicare baseline. Located in 1001 Johnson Ferry Road, Atlanta, GA.

Cash / Self-Pay

$1,232

Average discount available for prompt cash payment at this facility.

Insurance Median

$844

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: $1,232 (1153%)

Insurance Median: $844 (790%)

Cash: $1,232 (1153% of Medicare)

Ins. Median: $844 (790% 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 790% of the Medicare baseline (a markup of 690%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Peachstate [43]	$515	482%
Caresource [61]	$529	495%
Amerigroup [102]	$534	500%
Cigna	$814	762%
Blue Cross Blue Shield	$817 - $1,203	765%
United [5]	$817	765%
Ambetter / Centene	$825	772%
Oscar [228]	$825	772%
Aetna	$829	776%
Caresource Marketplace Bronze/Silver/Gold [60]	$837	784%
Kaiser [6]	$839	786%
Sidecar Health [236]	$850	796%
Direct Employer Agreements [72]	$862 - $1,047	807%
Coventry [9]	$865	810%
Northeast Georgia Heatlh System [808]	$924	865%
Veracity Benefits [809]	$924	865%
First Health [74]	$925	866%
Phcs [93]	$1,047	980%
Secure Health [340]	$1,047	980%
Beech Street [71]	$1,109	1038%
Multiplan [92]	$1,207	1130%
Novanet [41]	$1,232	1153%

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 $1,232.
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 Children's Healthcare of Atlanta at Scottish Rite 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.