CMS Price Transparency Data

Ultrasound, pelvis

Facility: Atlanticare Regional Medical Center - City Campus

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $1,028
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 9.62x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Atlanticare Regional Medical Center - City Campus is $1,028. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 9.62x the Medicare baseline. Located in 1925 Pacific Avenue, Atlantic City, NJ.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,028

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%)
Insurance Median: $1,028 (962%)
Ins. Median: $1,028 (962% 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 962% of the Medicare baseline (a markup of 862%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Tricare $106 99%
Devoted Health Plan $121 113%
Oxford $174 163%
UnitedHealthcare $174 - $796 163%
Global Exchange Managed Care $176 165%
Americhoice $177 166%
Wellcare $189 177%
Horizon $191 - $960 179%
Self Pay $206 193%
Health Partners Plan $235 220%
Magnacare $549 - $1,235 514%
Cigna $576 - $691 539%
Evernorth $686 642%
Qualcare Commercial $686 642%
Great West Life $691 647%
Aetna $789 - $1,133 739%
Amerihealth $882 - $1,153 826%
Active Care Plus $892 835%
First Mco $892 835%
Mutual Of Omaha $892 835%
Qualcare Wc $892 835%
Consumer Health Network (Chn) $960 - $1,235 899%
Donio Trucking $960 899%
Devon/ Ullicare $1,029 963%
Coventry Health Care $1,098 1028%
Private Healthcare System (Phcs) $1,098 1028%
Blue Cross Blue Shield $1,129 1057%
Health Payors Org $1,166 1092%
Health South $1,166 1092%
Metrahealth Of Nj $1,166 1092%
Prime Health Services $1,166 1092%
Three Rivers Provider Network (Trpn) $1,166 1092%
Active Care Nj Pip $1,235 1156%
Beech Street $1,235 1156%
Choice Care $1,235 1156%
Department Of Corrections $1,235 1156%
Galaxy Health Network $1,235 1156%
Health Network Inc $1,235 1156%
Intergroup Preferred Program $1,235 1156%
Mcs Commercial $1,235 1156%
Metracomp $1,235 1156%
Multiplan $1,235 1156%
Provider Select, Inc $1,235 1156%
Atlantis Health Plan $1,269 1188%
Master Care Inc $1,269 1188%
Advance Healthcare System $1,303 1220%
Community Care Network $1,303 1220%
Health Network America $1,303 1220%
Mcsi/Mrsi No Fault $1,303 1220%
Mcsi/Mrsi Worker'S Comp $1,303 1220%
National Health Plan $1,303 1220%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1925 Pacific Avenue, Atlantic City, NJ 08401
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals