CMS Price Transparency Data

Ultrasound, pelvis

Facility: Cambridge Health Alliance

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $798
  • Cash Discount Price: $798
  • vs. Medicare Baseline: 7.47x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Cambridge Health Alliance is $798. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $798. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 7.47x the Medicare baseline. Located in 1493 Cambridge Street, Cambridge, MA.
Cash / Self-Pay
$798

Average discount available for prompt cash payment at this facility.

Insurance Median
$798

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: $798 (747%)
Insurance Median: $798 (747%)
Cash: $798 (747% of Medicare)
Ins. Median: $798 (747% 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 747% of the Medicare baseline (a markup of 647%). 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
Blue Cross Blue Shield $129 - $798 121%
Wc [90001] $132 124%
Wellpoint [50012] $153 143%
Aarp [40001] $250 234%
Oxford Health [40004] $250 234%
United Medical Resource [40005] $250 234%
UnitedHealthcare $250 - $324 234%
Aetna $276 - $798 258%
Health Plans Inc [20002] $324 303%
Hphc [20001] $324 303%
Cigna $352 - $1,129 330%
Tufts Health Plan [30001] $352 - $423 330%
Mass General Brigham [50021] $508 476%
Multiplan [50010] $543 508%
Altus Dental [99011] $798 747%
Beacon Health Strategies [50002] $798 747%
Cbhc Uninsured Crisis Alt Payer [70097] $798 747%
Cbhc Uninsured Crisis [70096] $798 747%
Celticare [50004] $798 747%
Commonwealth Care Alliance Dental [99004] $798 747%
Coverage Discovery [90004] $798 747%
Delta Dental Of Ma [99007] $798 747%
Dominion National Dental [99012] $798 747%
Dph Tb Payor [85004] $798 747%
Esp Dental [99003] $798 747%
Eyemed Alt Payor [13001] $798 747%
First Health [50007] $798 747%
Global Medical Management [50024] $798 747%
Government Employee Health Association [50023] $798 747%
Guardian Dental [99013] $798 747%
Health Safety Net Dental [99002] $798 747%
Humana $798 747%
Ma Laborers Health And Welfare Fund [50022] $798 747%
Magellan Health Services [65098] $798 747%
Mass Health Dental [99001] $798 747%
Medical Mutual Of Ohio [50019] $798 747%
Medicare (plans) $798 747%
Metlife Dental [99008] $798 747%
Modern Assistance Program [30098] $798 747%
Mva [90002] $798 747%
Neighborhood Health Plan [50011] $798 747%
Other Bh Payor [50014] $798 747%
Other Commercial Payor [50015] $798 747%
Other Dental Payor [99014] $798 747%
Other Dual Eligible Payer [65004] $798 747%
Other Gov'T Alt [85006] $798 747%
Other Vision Payor [50013] $798 747%
Ri Neighborhood Health Plan [50017] $798 747%
Tricare $798 747%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1493 Cambridge Street, Cambridge, MA 02139
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals