CMS Price Transparency Data

Ultrasound, pelvis

Facility: Crystal Clinic Orthopaedic Center

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $1,088
Cash Discount Price: $557
vs. Medicare Baseline: 10.19x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Crystal Clinic Orthopaedic Center is $1,088. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $557. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 10.19x the Medicare baseline. Located in 444 North Main Street, Akron, OH.

Cash / Self-Pay

$557

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,088

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: $557 (521%)

Insurance Median: $1,088 (1019%)

Cash: $557 (521% of Medicare)

Ins. Median: $1,088 (1019% 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 1019% of the Medicare baseline (a markup of 919%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Bc Mcr Adv	$99	93%
Summacare Mcr Adv	$99	93%
UnitedHealthcare	$99 - $1,561	93%
The Health Plan - All Plans	$198	185%
Aultcare - All Plans	$237	222%
Health Oh Network - All Plans	$445	417%
Ohio Health Choice - All Plans	$445	417%
Med Mutual Nas	$463	433%
Multiplan - All Plans	$490	459%
Healthsmart - All Plans	$631	591%
Bc Pathway	$928	869%
Cigna	$1,248	1168%
Bc Ohi/Ohii	$1,274	1193%
Summacare Comm - All Other Plans	$1,373	1285%
Med Mutual Medflex	$1,389	1300%
Bc Blue Access	$1,415	1325%
Bc Preferred	$1,415	1325%
Bc Trad - All Other Plans	$1,415	1325%
Med Mutual Aca	$1,580	1479%
Med Mutual Ppo/Pos/Hmo - All Other Plans	$1,736	1625%
Aetna	$1,759	1647%

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 $557.
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 Crystal Clinic Orthopaedic 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.