CMS Price Transparency Data

Ultrasound, pelvis

Facility: Long Island Community Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $105
  • Cash Discount Price: $273
  • vs. Medicare Baseline: 0.98x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Long Island Community Hospital is $105. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $273. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.98x the Medicare baseline. Located in 101 Hospital Road, Patchogue, NY.
Cash / Self-Pay
$273

Average discount available for prompt cash payment at this facility.

Insurance Median
$105

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: $273 (256%)
Insurance Median: $105 (98%)
Cash: $273 (256% of Medicare)
Ins. Median: $105 (98% 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.

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
Local 1199 $52 49%
Magellan $68 64%
Multiplan $68 64%
Oscar Health Exchange $71 66%
Coventry $78 73%
Longevity Health $84 79%
Galaxy $94 88%
Aarp $105 98%
Aetna $105 - $290 98%
Beacon Health Options $105 98%
Blue Cross Blue Shield $105 - $820 98%
Centerlight $105 98%
Cigna $105 - $411 98%
Emblem Ghi $105 98%
Fidelis $105 98%
Humana $105 98%
Integra $105 98%
Medicare (plans) $105 98%
UnitedHealthcare $105 - $294 98%
Agewell $108 101%
Elderplan Inc. $115 108%
Wellcare $115 108%
Nexus Nyu $265 248%
Magnacare $490 - $858 459%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 101 Hospital Road, Patchogue, NY 11772
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals