CMS Price Transparency Data

Ultrasound, pelvis

Facility: Mt Sinai Hospital Medical Center

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $116
  • Cash Discount Price: $394
  • vs. Medicare Baseline: 1.09x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Mt Sinai Hospital Medical Center is $116. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $394. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.09x the Medicare baseline. Located in 15Th Street at California, Chicago, IL.
Cash / Self-Pay
$394

Average discount available for prompt cash payment at this facility.

Insurance Median
$116

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: $394 (369%)
Insurance Median: $116 (109%)
Cash: $394 (369% of Medicare)
Ins. Median: $116 (109% 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
Partners In Hlth - All Plans $32 - $418 30%
Blue Cross Blue Shield $36 - $664 34%
Healthlink Hmo $41 - $522 38%
Healthlink Ppo - All Other Plans $41 - $522 38%
Compsych Ip/Op Only - All Plans $49 - $626 46%
Hfn Platinum $53 - $678 50%
Multiplan Primary Ntwrk/Phcs - All Other Plans $57 - $731 53%
Hfn Epo $65 - $835 61%
Multiplan Complementary Ntwrk $65 - $835 61%
Hfn Ppo - All Other Plans $71 - $919 66%
Ambetter / Centene $85 - $1,096 80%
Oscar - All Plans $85 - $1,096 80%
Cigna $100 - $1,290 94%
Tricare $109 102%
Va Healthnet - All Plans $109 102%
Advocate Physician Prtnrs Mcr $112 105%
Cenpatico Illinicare Dual $112 105%
Cenpatico Illinicare Mcr - All Other Plans $112 105%
Humana $112 - $3,278 105%
Lawndale Christian - All Plans $112 105%
Meridian/Harmony D-Snp - All Plans $112 105%
Nextlevel Hlth Icp Fhp Aca - All Plans $112 105%
UnitedHealthcare $112 - $522 105%
Harmony Behavioral Htlh - All Plans $115 108%
Zing Mcr Adv - All Plans $117 110%
Molina Mcr - All Other Plans $118 110%
Advocate Physician Prtnrs - All Other Plans $123 115%
Aetna $183 - $2,359 171%
Family Health Network Mcaid - All Plans $250 234%
Molina Mcaid $262 245%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 15Th Street at California, Chicago, IL 60608
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals