CMS Price Transparency Data

Ultrasound, pelvis

Facility: Ann & Robert H Lurie Childrens Hospital of Chicago

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $1,714
  • Cash Discount Price: $1,499
  • vs. Medicare Baseline: 16.05x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Ann & Robert H Lurie Childrens Hospital of Chicago is $1,714. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,499. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 16.05x the Medicare baseline. Located in 225 E Chicago Ave, Box 140, Chicago, IL.
Cash / Self-Pay
$1,499

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,714

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: $1,499 (1403%)
Insurance Median: $1,714 (1605%)
Cash: $1,499 (1403% of Medicare)
Ins. Median: $1,714 (1605% 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 1605% of the Medicare baseline (a markup of 1505%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Medicare (plans) $364 - $2,656 341%
UnitedHealthcare $590 - $633 552%
Mercycare Health $793 742%
Cigna $900 - $1,521 843%
Magellan $900 - $1,714 843%
Blue Cross Blue Shield $927 - $1,714 868%
Aetna $1,071 - $1,677 1003%
Beacon Health Options $1,071 1003%
La Rabida Childrens Hospital $1,071 1003%
Centegra $1,285 1203%
Independent Physicians At Mercy $1,285 1203%
Advanced Physicians Association Ipa $1,499 1403%
Health Plus $1,499 1403%
Imagine Health $1,499 1403%
Methodist First Choice $1,499 1403%
Northwest Community Healthcare $1,499 1403%
Presence Health Partners $1,499 1403%
St. Francis $1,499 1403%
Ui Health $1,499 1403%
West Suburban Health Providers $1,499 1403%
Shriners Hospital $1,606 1504%
Swedish Covenant Physician Partners $1,606 1504%
American Psych Systems $1,714 1605%
Health Alliance $1,714 1605%
Macneal Health $1,714 1605%
Healthlink Inc. $1,767 1654%
Cofinity $1,821 1705%
Hfn Inc $1,821 - $1,928 1705%
Humana $1,821 1705%
Principal Healthcare $1,821 1705%
St. Elizabeth $1,821 1705%
First Health $1,885 1765%
Healthstar $1,885 1765%
Preferred Health Network $1,885 1765%
Sagamore Health Network $1,885 1765%
Beech Street $1,928 1805%
Benchmark Health $1,928 1805%
Employer'S Coalition On Health $1,928 1805%
Private Health Care System $1,928 1805%
Security Health Plan $1,928 1805%
Swedish American $1,928 1805%
Wellmark/Healthnetwork $1,971 1845%
Health Smart $2,035 1905%
Integrated Health Plan $2,035 1905%
Multiplan $2,035 1905%
National Provider Network $2,035 1905%
Wea Insurance Group $2,035 1905%
Unicare $3,678 - $8,500 3443%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 225 E Chicago Ave, Box 140, Chicago, IL 60611
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens