CMS Price Transparency Data

Ultrasound, pelvis

Facility: Hackensack University Medical Center

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $275
  • Cash Discount Price: $125
  • vs. Medicare Baseline: 2.57x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Hackensack University Medical Center is $275. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $125. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.57x the Medicare baseline. Located in 30 Prospect Ave, Hackensack, NJ.
Cash / Self-Pay
$125

Average discount available for prompt cash payment at this facility.

Insurance Median
$275

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: $125 (117%)
Insurance Median: $275 (257%)
Cash: $125 (117% of Medicare)
Ins. Median: $275 (257% 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 257% of the Medicare baseline (a markup of 157%). 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
Karna $59 - $203 55%
Horizon $98 - $1,191 92%
UnitedHealthcare $100 - $337 94%
Blue Cross Blue Shield $125 117%
Wellcare $125 117%
Vaccn $125 117%
Aetna $127 - $306 119%
United Community/Americhoice $131 123%
Amerihealth $185 173%
Clover $220 206%
Cigna $271 - $977 254%
Oxford $337 316%
Seoul Medical Group $349 327%
Intergroup $855 800%
Bergen Risk $916 858%
Lhp Health $965 903%
Activecare First McO $1,038 972%
Multiplan - PHCS $1,038 972%
Chn $1,038 972%
Qualcare $1,077 1008%
Brighton Health Plan $1,099 1029%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 30 Prospect Ave, Hackensack, NJ 07601
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals