CMS Price Transparency Data

Ultrasound, pelvis

Facility: Strong Memorial Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $137
Cash Discount Price: $315
vs. Medicare Baseline: 1.28x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Strong Memorial Hospital is $137. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $315. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.28x the Medicare baseline. Located in 601 Elmwood Ave, Rochester, NY.

Cash / Self-Pay

$315

Average discount available for prompt cash payment at this facility.

Insurance Median

$137

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: $315 (295%)

Insurance Median: $137 (128%)

Cash: $315 (295% of Medicare)

Ins. Median: $137 (128% 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
Blue Cross Blue Shield	$56 - $358	52%
Excellus [2201]	$56	52%
Medicaid / KanCare	$56 - $213	52%
Molina Healthcare [1723], Molina Healthcare [5189]	$56	52%
Molina Healthcare [5189]	$56	52%
UnitedHealthcare	$56 - $262	52%
Mvp [2900]	$67 - $482	63%
Aetna	$97 - $432	91%
Elderplan [1316]	$97	91%
Excellus Bc/Bs [2201]	$97 - $183	91%
Icircle [1728]	$97	91%
Martins Point [1205]	$97 - $130	91%
Medicare (plans)	$97 - $174	91%
Nascentia [1729]	$97	91%
Humana	$98 - $161	92%
Highmark Bc/Bs Of Western Ny [5143]	$121	113%
Fidelis [5155]	$122 - $224	114%
Excellus Bc/Bs [2201], Bc/Bs Out Of Area [2401]	$141 - $340	132%
Independent Health [5156]	$183 - $221	171%
Cigna	$235 - $482	220%
Capital District Physicians Health Plan (Cdphp) [5149]	$260 - $348	243%

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 $315.
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 Strong Memorial 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.