CMS Price Transparency Data

Ultrasound, pelvis

Facility: Medstar Union Memorial Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $1,039
Cash Discount Price: $1,018
vs. Medicare Baseline: 9.73x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Medstar Union Memorial Hospital is $1,039. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,018. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 9.73x the Medicare baseline. Located in 201 East University Parkway, Baltimore, MD.

Cash / Self-Pay

$1,018

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,039

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: $1,018 (953%)

Insurance Median: $1,039 (973%)

Cash: $1,018 (953% of Medicare)

Ins. Median: $1,039 (973% 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 973% of the Medicare baseline (a markup of 873%). 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
Aetna	$1,039	973%
Amerigroup	$1,039	973%
Amerihealth Caritas District Of Columbia	$1,039	973%
Carefirst Advantage Inc	$1,039	973%
Carefirst Blue Choice Inc	$1,039	973%
Cigna	$1,039	973%
First Health	$1,039	973%
Hscsn	$1,039	973%
Humana	$1,039	973%
Kaiser Permanente	$1,039	973%
Magellan Behavioral Health Inc	$1,039	973%
Mamsi	$1,039	973%
Medstar Family Choice	$1,039	973%
Medstar Family Choice Inc	$1,039	973%
Ncppo Healthlink Ppo	$1,039	973%
Pfc	$1,039	973%
Private Healthcare Systems (Phcs)	$1,039	973%
Tricare	$1,039	973%
United Behavioral Health Inc	$1,039	973%
UnitedHealthcare	$1,039	973%

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 $1,018.
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 Medstar Union Memorial Hospital 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.