CMS Price Transparency Data

Ultrasound, pelvis

Facility: Barnes Jewish Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $499
Cash Discount Price: $509
vs. Medicare Baseline: 4.67x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Barnes Jewish Hospital is $499. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $509. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.67x the Medicare baseline. Located in One Barnes-Jewish Hospital Plaza, Saint Louis, MO.

Cash / Self-Pay

$509

Average discount available for prompt cash payment at this facility.

Insurance Median

$499

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: $509 (477%)

Insurance Median: $499 (467%)

Cash: $509 (477% of Medicare)

Ins. Median: $499 (467% 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 467% of the Medicare baseline (a markup of 367%). 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	$105 - $637	98%
Blue Cross Blue Shield	$105 - $739	98%
Essence Healthcare [221]	$105	98%
Humana	$105 - $260	98%
UnitedHealthcare	$105 - $631	98%
Cox Health [757]	$110	103%
Devoted Health Plan [847]	$110	103%
Medica [662]	$110	103%
Cigna	$222 - $679	208%
Consociate [478]	$259	242%
Sarah Bush Lincoln [636]	$259	242%
Apwu Health Plan [216]	$307	287%
Nalc Health Benefit Plan [242]	$307	287%
Priority Health [648]	$307	287%
Allied Benefits [498]	$317 - $631	297%
Coresource [497]	$317	297%
Fmh Benefit Service Inc [222]	$317	297%
Mail Handlers [495]	$317	297%
Healthlink [225]	$412 - $641	386%
Cox Health Systems Insurance Company [220]	$467 - $552	437%
Health Alliance [224]	$467	437%
Hope Trust [806]	$492	461%
Healthscope Benefits [258]	$518 - $553	485%
Med-Pay [480]	$552 - $637	517%
Unicare [568]	$552 - $641	517%
First Health Commercial [734]	$631	591%
Beechstreet [551]	$637	596%
Detego Health [868]	$637	596%
Health Systems Inc [620]	$637	596%
Healthcare Sol Mercy [609]	$637	596%
Multiplan Commercial [737]	$637	596%
Multiplan [240]	$637	596%
Phcs [244]	$637 - $679	596%
Preferred Health Professionals [561]	$641	600%
Medica [661]	$679	636%
Hfn [563]	$722	676%

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 $509.
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 Barnes Jewish 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.