CMS Price Transparency Data

Ultrasound, pelvis

Facility: Barnes-Jewish St Peters Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $563
  • Cash Discount Price: $614
  • vs. Medicare Baseline: 5.27x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Barnes-Jewish St Peters Hospital is $563. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $614. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.27x the Medicare baseline. Located in 10 Hospital Dr, Saint Peters, MO.
Cash / Self-Pay
$614

Average discount available for prompt cash payment at this facility.

Insurance Median
$563

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: $614 (575%)
Insurance Median: $563 (527%)
Cash: $614 (575% of Medicare)
Ins. Median: $563 (527% 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 527% of the Medicare baseline (a markup of 427%). 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
Aetna $105 - $768 98%
Blue Cross Blue Shield $105 - $891 98%
Essence Healthcare [221] $105 98%
Humana $105 - $223 98%
UnitedHealthcare $105 - $761 98%
Cox Health [757] $110 103%
Devoted Health Plan [847] $110 103%
Medica [662] $110 103%
Consociate [478] $219 205%
Sarah Bush Lincoln [636] $219 - $514 205%
Cigna $224 - $250 210%
Allied Benefits [498] $237 - $761 222%
Coresource [497] $237 222%
Fmh Benefit Service Inc [222] $237 222%
Mail Handlers [495] $237 222%
Apwu Health Plan [216] $250 234%
Nalc Health Benefit Plan [242] $250 234%
Priority Health [648] $250 234%
Healthlink [225] $497 - $773 465%
Healthscope Benefits [258] $514 481%
Cox Health Systems Insurance Company [220] $563 - $666 527%
Health Alliance [224] $563 527%
Hope Trust [806] $594 556%
Med-Pay [480] $666 - $768 624%
Unicare [568] $666 - $773 624%
First Health Commercial [734] $761 712%
Beechstreet [551] $768 719%
Detego Health [868] $768 719%
Health Systems Inc [620] $768 719%
Healthcare Sol Mercy [609] $768 719%
Multiplan Commercial [737] $768 719%
Multiplan [240] $768 719%
Phcs [244] $768 - $819 719%
Preferred Health Professionals [561] $773 724%
Hfn [563] $819 767%
Medica [661] $819 767%
Mh Magellan Health Services [270] $1,024 959%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 10 Hospital Dr, Saint Peters, MO 63376
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals