CMS Price Transparency Data

Ultrasound, pelvis

Facility: Akron General Medical Center

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $131
Cash Discount Price: $441
vs. Medicare Baseline: 1.23x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Akron General Medical Center is $131. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $441. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.23x the Medicare baseline. Located in 1 Akron General Avenue, Akron, OH.

Cash / Self-Pay

$441

Average discount available for prompt cash payment at this facility.

Insurance Median

$131

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: $441 (413%)

Insurance Median: $131 (123%)

Cash: $441 (413% of Medicare)

Ins. Median: $131 (123% 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
Summacare	$20 - $249	19%
Aetna	$31 - $976	29%
Blue Cross Blue Shield	$31 - $435	29%
Humana	$31 - $98	29%
The Health Plan	$31 - $469	29%
United	$31 - $251	29%
UnitedHealthcare	$31 - $586	29%
Valor	$31 - $98	29%
Communicare	$32 - $99	30%
Pphp	$33 - $108	31%
Zing Health	$34 - $108	32%
Aultcare	$40 - $373	37%
Cigna	$45 - $543	42%
Mmo	$59 - $683	55%
Buckeye	$72 - $125	67%
Caresource	$75 - $125	70%
Amerihealth	$79 - $137	74%
Molina	$79 - $131	74%
Oscar	$79 - $261	74%
Upmc	$95 - $407	89%
Perennial Health	$106	99%
Ohcp	$116 - $380	109%
United Bh	$132	124%
Omas	$148 - $488	139%
Phphi	$178 - $586	167%
Gms	$208 - $683	195%
Consociate Health	$223 - $732	209%
Multiplan	$267 - $878	250%
Cc Ehp	$271 - $275	254%
Amish Community Aid Plan	$306 - $340	286%
Ohio Healthy	$367	344%
Php	$407	381%
Medical Benefit Corp	$475	445%
Frontpath	$611	572%
Managed Care Services	$611	572%
Tertiary Care Network	$611	572%

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 $441.
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 Akron General Medical 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.