CMS Price Transparency Data

Ultrasound, pelvis

Facility: The Queens Medical Center

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $123
Cash Discount Price: $558
vs. Medicare Baseline: 1.15x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at The Queens Medical Center is $123. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $558. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.15x the Medicare baseline. Located in 1301 Punchbowl St, Honolulu, HI.

Cash / Self-Pay

$558

Average discount available for prompt cash payment at this facility.

Insurance Median

$123

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: $558 (522%)

Insurance Median: $123 (115%)

Cash: $558 (522% of Medicare)

Ins. Median: $123 (115% 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
Hmsa	$55 - $123	51%
UnitedHealthcare	$63 - $123	59%
Hawaii Community Health Alliance	$118	110%
Hawaii Mainland Administrators	$118 - $151	110%
Alohacare	$123 - $258	115%
Kaiser	$123 - $344	115%
Ohana Care	$123	115%
Hawaii Western Management Group	$168	157%
Hawaii Laborers	$214	200%
Seven Corners	$227	213%

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 $558.
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 The Queens Medical Center 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.