CMS Price Transparency Data

Ultrasound, pelvis

Facility: Christ Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $120
Cash Discount Price: $235
vs. Medicare Baseline: 1.12x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Christ Hospital is $120. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $235. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.12x the Medicare baseline. Located in 2139 Auburn Avenue, Cincinnati, OH.

Cash / Self-Pay

$235

Average discount available for prompt cash payment at this facility.

Insurance Median

$120

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: $235 (220%)

Insurance Median: $120 (112%)

Cash: $235 (220% of Medicare)

Ins. Median: $120 (112% 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	$63 - $575	59%
Caresource [2031]	$63 - $575	59%
Humana	$63 - $575	59%
Medicaid / KanCare	$63 - $575	59%
UnitedHealthcare	$65 - $575	61%
Aetna	$98 - $575	92%
Allied Benefits [2163]	$98 - $120	92%
Ambetter / Centene	$98 - $120	92%
Buckeye Mycare Dual [2171]	$98	92%
Cigna	$98 - $575	92%
Custom Design Benefits - True Cost [3004]	$98 - $120	92%
First Health [2041]	$98	92%
Medben [2222]	$98 - $120	92%
Medicare (plans)	$98 - $120	92%
Medigold Ppo [2204]	$98	92%
Meridian [2185]	$98	92%
Meritain Health [2224]	$98 - $120	92%
Other Exchange Plan [9992]	$98 - $575	92%
Perennial [4200]	$98	92%
Poppins Health [2299]	$98	92%
Amerihealth Caritas [2230]	$120 - $575	112%
Buckeye Community Health [2028]	$120 - $575	112%
Champva [2034]	$120	112%
Kentucky Passport/Molina [2097]	$120 - $144	112%
Medical Mutual [2054]	$120 - $289	112%
Multiplan/Phcs [2059]	$120 - $420	112%
Other Managed Care [9991]	$120	112%
Other [9990]	$120	112%
Priority Health [2225]	$120 - $306	112%
Tricare	$120	112%
Trustmark [2219]	$120	112%
United Medical Resources [2104]	$120 - $443	112%
Wellcare Of Kentucky [2191]	$120 - $144	112%
Western And Southern [2076]	$120 - $289	112%
Ohio Health Choice [2062]	$276	258%
Nalc [2178]	$306	286%
Life Synch [2080]	$345	323%
Geha [2168]	$443	415%
Golden Rule [2161]	$443	415%
Bccp [3079]	$575	538%
Healthcare Highways [2298]	$575	538%
Sagamore Health Network [2066]	$575	538%
Suburban Health [2408]	$575	538%

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 $235.
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 Christ 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.