CMS Price Transparency Data
Ultrasound, pelvis
Facility: Trinity Health Livingston Hospital
Billing Code: 76856 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 76856
- Insurance Median: $264
- Cash Discount Price: $1,147
- vs. Medicare Baseline: 2.47x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Trinity Health Livingston Hospital is $264. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,147. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.47x the Medicare baseline. Located in 620 Byron Rd, Howell, MI.
Cash / Self-Pay
$1,147
Average discount available for prompt cash payment at this facility.
Insurance Median
$264
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: $1,147 (1074%)
Insurance Median: $264 (247%)
Cash: $1,147 (1074% of Medicare)
Ins. Median: $264 (247% 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 247% of the Medicare baseline (a markup of 147%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
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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 | $58 - $116 | 54% |
| Medicaid / KanCare | $58 - $60 | 54% |
| Aetna | $82 - $571 | 77% |
| Geha | $82 - $884 | 77% |
| Meritain | $82 | 77% |
| Huron Valley Pace | $99 | 93% |
| Blue Care Network Advantage | $102 | 95% |
| Hospice Of Lansing | $102 | 95% |
| Medicare (plans) | $102 - $104 | 95% |
| Align Senior Care | $104 | 97% |
| Angela Hospice | $105 | 98% |
| UnitedHealthcare | $108 - $1,087 | 101% |
| Cca - Zing Health | $110 | 103% |
| Bcn Domestic | $116 | 109% |
| Blue Benefit Administrators Of Massachusetts | $116 | 109% |
| Blue Care Network | $116 | 109% |
| Blue Distinction Transplant | $116 | 109% |
| Blue Shield - Ca | $116 | 109% |
| Blue Shield - Id (Regence) | $116 | 109% |
| Blue Shield - Ny Highmark Northeastern | $116 | 109% |
| Blue Shield - Ny Highmark Western | $116 | 109% |
| Blue Shield - Pa (Highmark) | $116 | 109% |
| Blue Shield - Wa (Regence) | $116 | 109% |
| Health Choices | $116 - $984 | 109% |
| Kaiser Domestic | $116 | 109% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $118 | 110% |
| Molina Marketplace | $136 | 127% |
| Health Cost Solutions | $162 | 152% |
| Vitalcore | $162 | 152% |
| Wellpath | $162 | 152% |
| Priority Health | $165 - $183 | 154% |
| Asr Health Benefits | $199 | 186% |
| Caresource | $199 | 186% |
| Hap | $199 - $935 | 186% |
| Varipro | $199 | 186% |
| U Of M Health Plan | $229 | 214% |
| Employee Benefit Logistic | $235 | 220% |
| Wc Accident Fund | $264 | 247% |
| Wc Advantage | $264 | 247% |
| Wc Aig | $264 | 247% |
| Wc Allied | $264 | 247% |
| Wc Amerisure | $264 | 247% |
| Wc Amtrust | $264 | 247% |
| Wc Asu Risk Mgt | $264 | 247% |
| Wc Berkley Admin | $264 | 247% |
| Wc Broadspire | $264 | 247% |
| Wc Bunch & Associates | $264 | 247% |
| Wc Ccmsi | $264 | 247% |
| Wc Emc Insurance Company | $264 | 247% |
| Wc Esis | $264 | 247% |
| Wc Fcci | $264 | 247% |
| Wc Federated | $264 | 247% |
| Wc Gallagher Bassett | $264 | 247% |
| Wc Genex Care For Ohio | $264 | 247% |
| Wc Guard Insurance Company | $264 | 247% |
| Wc Hartford | $264 | 247% |
| Wc Liberty Mutual | $264 | 247% |
| Wc Meijers | $264 | 247% |
| Wc Michigan | $264 | 247% |
| Wc Mitchell Frankenmuth | $264 | 247% |
| Wc Pma | $264 | 247% |
| Wc Sedgwick | $264 | 247% |
| Wc Sentry | $264 | 247% |
| Wc Travelers | $264 | 247% |
| Wc Tristar | $264 | 247% |
| Wc Walmart | $264 | 247% |
| Wc Zurich | $264 | 247% |
| Acs Benefit Services | $570 | 534% |
| Allied Benefit Systems | $570 | 534% |
| Claimchoice Adminstrators | $570 | 534% |
| Consociate | $570 | 534% |
| Cypress Benefit Administrators | $570 | 534% |
| Forest County Potawatomi | $570 | 534% |
| Health Smart | $570 | 534% |
| Healthgram | $570 | 534% |
| Healthscope | $570 | 534% |
| Secureone Preferred United Plans | $570 | 534% |
| Sisco Benefits | $570 | 534% |
| The Health Plan | $570 | 534% |
| Trustmark Small Business Benefits | $570 | 534% |
| Unified Group Services | $570 | 534% |
| Webtpa | $570 | 534% |
| Hospice Advantage | $846 | 792% |
| 1199 National Benefit Fund | $930 | 871% |
| Allied National Global Care | $930 | 871% |
| Asrm - Reliance Standard Life Insurance | $930 | 871% |
| Christian Care Ministry | $930 | 871% |
| Dean Health | $930 | 871% |
| Fallon Health | $930 | 871% |
| Family Life Insurance Company | $930 | 871% |
| Ghc Scw | $930 | 871% |
| Group Pension Administrators | $930 | 871% |
| International Benefit Administrators | $930 | 871% |
| Lifetime Benefit Solutions | $930 | 871% |
| Manhattan Life | $930 | 871% |
| Medi Share | $930 | 871% |
| Multiplan | $930 | 871% |
| Mvp | $930 | 871% |
| Pai | $930 | 871% |
| Pan-American Life | $930 | 871% |
| Paramount Hmo | $930 | 871% |
| Phcs | $930 | 871% |
| Trinity Health Share | $930 | 871% |
| Health Partners | $935 | 875% |
| Tufts Health Plan | $935 | 875% |
| Cigna | $938 | 878% |
| Prime Health Services | $966 | 904% |
| Access Health | $984 | 921% |
| Acclaim | $984 | 921% |
| Administrative Concepts | $984 | 921% |
| Allegeant | $984 | 921% |
| Ameriben | $984 | 921% |
| American Family | $984 | 921% |
| American Healthcare Alliance | $984 | 921% |
| American National | $984 | 921% |
| American Republic | $984 | 921% |
| Amerihealth | $984 | 921% |
| Aultcare | $984 | 921% |
| Automated Benefit Services | $984 | 921% |
| Auxiant | $984 | 921% |
| Benefit Administrative Systems,Llc | $984 | 921% |
| Boon Chapman | $984 | 921% |
| Cam Administrative Services | $984 | 921% |
| Christian Brother Services | $984 | 921% |
| Christian Brothers Holy Cross | $984 | 921% |
| Comprehensive Benefits | $984 | 921% |
| Continental Life Insurance | $984 | 921% |
| Coventry | $984 | 921% |
| Custom Benefit Administrators | $984 | 921% |
| Employee Benefit Concepts | $984 | 921% |
| Employee Benefit Management | $984 | 921% |
| Enterprise Group Planning | $984 | 921% |
| Freedom Life Insurance Company | $984 | 921% |
| Group Administrators | $984 | 921% |
| Group Marketing Services | $984 | 921% |
| Guardian | $984 | 921% |
| Health America | $984 | 921% |
| Healthcare Management Admin | $984 | 921% |
| Healthez | $984 | 921% |
| Humana | $984 | 921% |
| Insight | $984 | 921% |
| Intercare | $984 | 921% |
| Jfp Benefit Management | $984 | 921% |
| Jp Farley Corporation | $984 | 921% |
| Key Benefit Administrator | $984 | 921% |
| Liberty Union Life Assurance Co | $984 | 921% |
| Lucent Health | $984 | 921% |
| Luminare Health | $984 | 921% |
| Luminare Health (Detroit) | $984 | 921% |
| Magnacare | $984 | 921% |
| Medben | $984 | 921% |
| Medcost | $984 | 921% |
| Medical Mutual | $984 | 921% |
| Mutual Health Services | $984 | 921% |
| Mutual Of Omaha | $984 | 921% |
| Ncas | $984 | 921% |
| Nippon Life Ins | $984 | 921% |
| Nova | $984 | 921% |
| Painters Union Insurance Fund | $984 | 921% |
| Physicians Mutual | $984 | 921% |
| Plumbers Local 98 Insurance Fund | $984 | 921% |
| Prairie States | $984 | 921% |
| Preferred One | $984 | 921% |
| Primary Physician Care | $984 | 921% |
| Professional Benefit Administrators | $984 | 921% |
| Siho Insurance Services | $984 | 921% |
| The Loomis Company | $984 | 921% |
| Unicare | $984 | 921% |
| Us Health And Life | $984 | 921% |
| Valenz | $984 | 921% |
| Western & Southern Financial Group | $984 | 921% |
| Wps | $984 | 921% |
| First Health | $1,009 | 945% |
| Correctional Healthcare Consultants | $1,069 | 1001% |
| Three Rivers Provider Network | $1,087 | 1018% |
| Cmh Washtenaw County | $1,208 | 1131% |