CMS Price Transparency Data

Ultrasound, pelvis

Facility: Robert Wood Johnson University Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $178
Cash Discount Price: $239
vs. Medicare Baseline: 1.67x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Robert Wood Johnson University Hospital is $178. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $239. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.67x the Medicare baseline. Located in One Robert Wood Johnson Place, New Brunswick, NJ.

Cash / Self-Pay

$239

Average discount available for prompt cash payment at this facility.

Insurance Median

$178

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: $239 (224%)

Insurance Median: $178 (167%)

Cash: $239 (224% of Medicare)

Ins. Median: $178 (167% 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
Wellpoint	$35 - $123	33%
Blue Cross Blue Shield	$108 - $933	101%
Aetna	$123 - $205	115%
Clover Health	$123	115%
Fidelis Care	$123 - $179	115%
Humana	$123	115%
UnitedHealthcare	$126 - $177	118%
Amerihealth	$130	122%
Wellcare	$246	230%
Emblem Health	$259	242%
Cigna	$382	358%
Qualcare Inc	$426	399%
First Health	$673	630%

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 $239.
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 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.