CMS Price Transparency Data

Ultrasound, pelvis

Facility: Shirley Ryan Abilitylab

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $1,682
Cash Discount Price: $1,294
vs. Medicare Baseline: 15.75x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Shirley Ryan Abilitylab is $1,682. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,294. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 15.75x the Medicare baseline. Located in 355 E Erie St, Chicago, IL.

Cash / Self-Pay

$1,294

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,682

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: $1,294 (1211%)

Insurance Median: $1,682 (1575%)

Cash: $1,294 (1211% of Medicare)

Ins. Median: $1,682 (1575% 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 1575% of the Medicare baseline (a markup of 1475%). 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
Uic Physician Group-Campuscare	$1,078	1009%
Personalcare Insurance Of Il/Firsthealth Grp Corp/Coventryhealth And Life Insurance Co	$1,148 - $1,833	1075%
State Of Illinois	$1,148	1075%
Affordable Health Care Concepts	$1,296	1213%
University Of Chicago Practice Plan	$1,402	1313%
Health Care Services Corporation Dba Managed Care Network Preferred	$1,469	1375%
Gallagher Benefit Administrators	$1,618	1515%
Unicare Life And Health Insurance	$1,682	1575%
Private Healthcare Systems	$1,726	1616%
Resurrection Health Care Preferred	$1,726	1616%
Uic Physician Group	$1,747	1636%
Cofinity Aka Ppom	$1,833	1716%
Health Payors Organization	$1,833	1716%
Healthnetwork	$1,898	1777%
Hfn	$1,941	1817%

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 $1,294.
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 Shirley Ryan Abilitylab 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.