CMS Price Transparency Data

Ultrasound, pelvis

Facility: Adventist Health Castle

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $125
  • Cash Discount Price: $54
  • vs. Medicare Baseline: 1.17x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Adventist Health Castle is $125. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $54. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.17x the Medicare baseline. Located in 640 Ulukahiki St, Kailua, HI.
Cash / Self-Pay
$54

Average discount available for prompt cash payment at this facility.

Insurance Median
$125

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: $54 (51%)
Insurance Median: $125 (117%)
Cash: $54 (51% of Medicare)
Ins. Median: $125 (117% 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
Pacific Admin Ppo - All Plans $29 - $462 27%
Alohacare Quest Mcaid - All Other Plans $33 - $182 31%
Kfh Mcr Adv $33 - $124 31%
Medicare (plans) $33 - $124 31%
UnitedHealthcare $33 - $50 31%
Devoted Hlth Mcr Adv - All Plans $34 - $130 32%
Alohacare Mcr Adv Profee Only $35 33%
Health Alliance - All Plans $47 - $582 44%
Multiplan Hmn - All Plans $47 - $188 44%
State Of Hi Nonprofit - All Plans $74 - $1,272 69%
Hwmg/Hmaa - All Plans $105 - $535 98%
First Health Ppo - All Plans $106 - $683 99%
Medicaid / KanCare $113 - $727 106%
Ohana Health Plan - All Plans $113 - $126 106%
Hmsa Hmo $114 107%
Hmsa Ppo - All Other Plans $114 107%
Mdx Hawaii Ppo - All Plans $136 - $580 127%
Kfh - All Other Plans $144 - $618 135%
Uni Health Alliance - All Plans $159 - $678 149%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 640 Ulukahiki St, Kailua, HI 96734
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals