CMS Price Transparency Data

Ultrasound, pelvis

Facility: Greater Baltimore Medical Center

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $112
Cash Discount Price: $218
vs. Medicare Baseline: 1.05x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Greater Baltimore Medical Center is $112. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $218. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.05x the Medicare baseline. Located in 6701 North Charles Street, Baltimore, MD.

Cash / Self-Pay

$218

Average discount available for prompt cash payment at this facility.

Insurance Median

$112

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: $218 (204%)

Insurance Median: $112 (105%)

Cash: $218 (204% of Medicare)

Ins. Median: $112 (105% 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.

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	$88 - $125	82%
Md Physician Care [237]	$88	82%
Medicaid / KanCare	$88	82%
Priority Partners [241]	$88	82%
UnitedHealthcare	$88 - $118	82%
Wellpoint [235]	$88	82%
Alterwood Health [290]	$90	84%
Jai Medical Services [236]	$93	87%
Carefirst Maryland Health Advantage Mca [264]	$112	105%
Carefirst [201]	$112 - $211	105%
Cfchp Mco [239]	$112	105%
Cigna	$112 - $126	105%
Communicare Advantage [300]	$112	105%
Humana	$112	105%
Johns Hopkins [213]	$112 - $151	105%
Keycare Advantage [299]	$112	105%
Medicare (plans)	$112	105%
Provider Partners Health Plan [298]	$112	105%
Multiplan/Phcs [296]	$129	121%
Carefirst Blue Choice Hmo [253]	$138 - $198	129%
Carefirst Administrator [252]	$146 - $211	137%
First Health Network [268]	$146	137%
Kaiser Permanente Hmo [231]	$158	148%
Usa Managed Care Organization [301]	$172	161%
All Payers	$368	345%

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 $218.
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 Greater Baltimore Medical Center 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.