CMS Price Transparency Data

Ultrasound, pelvis

Facility: Robert Wood Johnson University Hospital at Rahway

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $152
Cash Discount Price: $172
vs. Medicare Baseline: 1.42x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Robert Wood Johnson University Hospital at Rahway is $152. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $172. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.42x the Medicare baseline. Located in 865 Stone St, Rahway, NJ.

Cash / Self-Pay

$172

Average discount available for prompt cash payment at this facility.

Insurance Median

$152

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: $172 (161%)

Insurance Median: $152 (142%)

Cash: $172 (161% of Medicare)

Ins. Median: $152 (142% 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.

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
Blue Cross Blue Shield	$108 - $680	101%
Aetna	$116 - $356	109%
Clover Health	$116	109%
Fidelis Care	$116 - $152	109%
Humana	$116	109%
Wellpoint	$116	109%
UnitedHealthcare	$119 - $177	111%
Amerihealth	$121 - $130	113%
Emblem Health	$203	190%
Wellcare	$231	216%
Cigna	$382	358%
First Health	$799	748%
Qualcare Inc	$894	837%

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 $172.
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 Robert Wood Johnson University Hospital at Rahway 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.