CMS Price Transparency Data

Ultrasound, pelvis

Facility: The University Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $198
Cash Discount Price: $140
vs. Medicare Baseline: 1.85x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at The University Hospital is $198. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $140. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.85x the Medicare baseline. Located in 150 Bergen St, Newark, NJ.

Cash / Self-Pay

$140

Average discount available for prompt cash payment at this facility.

Insurance Median

$198

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: $140 (131%)

Insurance Median: $198 (185%)

Cash: $140 (131% of Medicare)

Ins. Median: $198 (185% 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
Amerihealth	$58 - $121	54%
Aetna	$121 - $198	113%
Clover Health	$121	113%
Fidelis	$121 - $184	113%
Horizon	$121 - $243	113%
UnitedHealthcare	$121 - $184	113%
Wellpoint	$188	176%
First Health	$439	411%
Americare	$470	440%
Qualcare	$470	440%
Correctional Medical Services	$502	470%
Multiplan	$502	470%
First Trenton	$565	529%
Managed Care Inc	$565	529%
Consumer Health Network	$596	558%
Three Rivers	$596	558%

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 $140.
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 The 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.