CMS Price Transparency Data

Ultrasound, pelvis

Facility: University Medical Center of Princeton at Plainsboro

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $1,838
  • Cash Discount Price: $3,106
  • vs. Medicare Baseline: 17.21x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at University Medical Center of Princeton at Plainsboro is $1,838. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,106. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 17.21x the Medicare baseline. Located in One-Five Plainsboro Road, Plainsboro, NJ.
Cash / Self-Pay
$3,106

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,838

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: $3,106 (2908%)
Insurance Median: $1,838 (1721%)
Cash: $3,106 (2908% of Medicare)
Ins. Median: $1,838 (1721% 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 1721% of the Medicare baseline (a markup of 1621%). 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
Horizon Nj Health $106 99%
Tricare $118 110%
Aetna $119 - $2,587 111%
Blue Cross Blue Shield $119 - $2,336 111%
Medicare (plans) $119 - $131 111%
UnitedHealthcare $119 - $884 111%
Va Medical Center $119 111%
Cigna $123 - $3,106 115%
Clover Health Plan $126 118%
Humana $129 121%
Us Family Health Plan $135 126%
Elap $169 - $215 158%
Centivo $215 201%
Claim Watcher $215 201%
Medicaid / KanCare $286 - $3,106 268%
Charity Care $291 272%
Wellcare $315 295%
Preferred Health Care Eliance $808 756%
Horizon Behavioral Health $1,164 1090%
Beacon Health Options $1,553 1454%
Amerihealth $1,838 1721%
Magnacare $1,864 - $2,174 1745%
Princeton Theological Seminary $2,019 1890%
Coventry $2,174 2035%
Health Net $2,174 2035%
Beech Street $2,485 - $2,640 2327%
Intergrated Health Plan $2,485 2327%
Intergroup $2,485 2327%
Penn Global Medicine Embassy Only $2,485 2327%
Allied Trades $2,640 2472%
Consumer Health Network $2,640 2472%
Devon Health Services $2,640 2472%
First Managed Care Option $2,640 2472%
Ie Shaffer $2,640 2472%
Private Healthcare Systems $2,640 2472%
Qualcare $2,640 2472%
Total Care Network $2,640 2472%
Tri-State $2,640 2472%
Commercial Other $3,106 2908%
Compsych $3,106 2908%
Concern Plus $3,106 2908%
International Pfs $3,106 2908%
Life St. Francis $3,106 2908%
Magellan $3,106 2908%
Managed Health Network $3,106 2908%
Nj Carpenters $3,106 2908%
Penn Behavioral Health Corporate Services $3,106 2908%
Personnel Health Program $3,106 2908%
United Behavioral Health $3,106 2908%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One-Five Plainsboro Road, Plainsboro, NJ 08536
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals