CMS Price Transparency Data

Ultrasound, pelvis

Facility: Bellevue Hospital Center

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $178
Cash Discount Price: $127
vs. Medicare Baseline: 1.67x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Bellevue Hospital Center is $178. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $127. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.67x the Medicare baseline. Located in 462 First Avenue, New York, NY.

Cash / Self-Pay

$127

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: $127 (119%)

Insurance Median: $178 (167%)

Cash: $127 (119% 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
Aetna	$26 - $1,131	24%
Healthfirst	$28 - $1,783	26%
Amidacare	$35 - $792	33%
Emblem	$35 - $1,070	33%
Wellcare	$38 - $137	36%
Metroplus	$45 - $1,783	42%
Fidelis	$50 - $1,783	47%
Oscar	$52 - $189	49%
Blue Cross Blue Shield	$97 - $1,783	91%
Affinity	$103 - $1,783	96%
Centerlight	$117 - $763	110%
Elderplan	$117 - $992	110%
Centers Plan For Healthy Living	$122 - $131	114%
Hamaspik	$123	115%
Local 1199	$123 - $1,297	115%
Vaccn	$126	118%
Vnsny	$126 - $1,297	118%
Oxford	$132 - $915	124%
United	$132 - $1,221	124%
Cigna	$177 - $1,144	166%
Villagecare Max	$191 - $1,297	179%
Carelon	$792 - $992	742%
Senior Whole Health	$792	742%
United Behavioral Health	$792 - $872	742%
Carelon (Amida Care)	$808	756%
Magnacare	$1,144	1071%
Multiplan	$1,221	1143%

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 $127.
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 Bellevue Hospital Center 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.