CMS Price Transparency Data

Ultrasound, pelvis

Facility: Ohio State University State Health System

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $248
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 2.32x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Ohio State University State Health System is $248. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.32x the Medicare baseline. Located in 410 West 10Th Avenue, Columbus, OH.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$248

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%)
Insurance Median: $248 (232%)
Ins. Median: $248 (232% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 232% of the Medicare baseline (a markup of 132%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Aetna $102 - $444 95%
Blue Cross Blue Shield $102 - $537 95%
Medicare (plans) $102 - $110 95%
Medigold $102 95%
Mmo $102 - $337 95%
Molina $102 - $170 95%
Upper Ohio Valley $102 - $364 95%
Humana $104 - $254 97%
Buckeye Community $105 - $158 98%
Caresource $107 - $158 100%
Healthspan $107 - $265 100%
Osu Health Plan $171 - $276 160%
Ohio Ppo $206 - $247 193%
Odrc $224 210%
Cigna $347 325%
Ohiohealth $359 - $414 336%
Lifetrac $375 351%
Frontpath $442 414%
Multiplan $442 414%
Healthsmart $497 465%
United $698 653%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 410 West 10Th Avenue, Columbus, OH 43210
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - State
  • Hospital Type: Acute Care Hospitals