CMS Price Transparency Data

Ultrasound, pelvis

Facility: Community Medical Center

Billing Code: 76856 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$141

about 1.3× the $107 Medicare rate · typically $122–$157

modeled estimate · not a bill or quote

What this hospital charges insurers

$152

About the fair price

about $11 over the fair price · 1.4× Medicare

Medicare pays $107 Fair price $141 This hospital $152 Cash price $236 Hospital's list price $1,138

How we calculate the fair BaseRate →

How this hospital compares to other NJ hospitals

Highest price of the 9 NJ hospitals we have prices for — worth calling around.

Cheapest $66 Priciest $152

Black dot = this hospital, among the 9 NJ hospitals with a price for this procedure. Full list below.

A fair price for a Ultrasound, pelvis is about $141 (about 1.3× the $107 Medicare rate). Community Medical Center charges insurers about $152, or about $236 in cash — about the fair price. Located in Toms River, NJ.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$119 - $177	111%
Blue Cross Blue Shieldmajor	$108 - $1,041	101%
Aetnamajor	$116 - $185	109%
Cignamajor	$382	358%
Humanamajor	$116	109%
AmeriHealth	$130	122%
Clover Health	$116	109%
Fidelis Care	$116 - $144	109%
WellCare	$231	216%
+ 2 smaller / regional plans	$203 - $809

Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 236), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 76856.

Insurance Before you use insurance

Call your insurance company to confirm Community Medical Center is in-network.
Ask your insurer whether prior approval is required for CPT code 76856.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Community Medical Center

Compare: Ultrasound, pelvis at other NJ hospitals

Insurance negotiated median for the same procedure, sorted lowest first.