CMS Price Transparency Data

Ultrasound, pelvis

Facility: University Hospitals Avon Rehabilitation Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $910
  • Cash Discount Price: $910
  • vs. Medicare Baseline: 8.52x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at University Hospitals Avon Rehabilitation Hospital is $910. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $910. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 8.52x the Medicare baseline. Located in 37900 Chester Rd, Avon, OH.
Cash / Self-Pay
$910

Average discount available for prompt cash payment at this facility.

Insurance Median
$910

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: $910 (852%)
Insurance Median: $910 (852%)
Cash: $910 (852% of Medicare)
Ins. Median: $910 (852% 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 852% of the Medicare baseline (a markup of 752%). 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
Uh Employees (Administered By Meritian) $354 331%
Blue Cross Blue Shield $523 - $910 490%
Healthsmart (Formerly Emerald) $592 554%
Ohio Health Choice - Preferred Choice Plus $592 554%
Clarity Health (Enterprise Group Planning Will Be Listed On Id Card As Well) $674 631%
Occunet Fka Health Ohio Network $674 631%
Paramount $683 - $910 639%
Ohio Preferred Network $728 682%
First Health $774 725%
Beechstreet $819 767%
Fortified $819 767%
Multiplan $819 767%
Ohio Health Choice $819 767%
Phcs $819 767%
Aetna $910 852%
Ambetter / Centene $910 852%
Amerihealth Cartias $910 852%
Antidote Healthe Care Of Ohio $910 852%
Aultcare $910 852%
Buckeye $910 852%
Caresource $910 852%
Caresource (Marketplace) $910 852%
Cigna $910 852%
Devoted $910 852%
Health Plan $910 852%
Humana $910 852%
Jp Farley (Select Employers) $910 852%
Medical Mutual $910 852%
Medical Mutual (Supermed, Trad, Medflex) $910 852%
Medical Mutual (Marketplace Plan) $910 852%
Molina $910 852%
Summacare $910 852%
United $910 852%
UnitedHealthcare $910 852%
Wellcare $910 852%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 37900 Chester Rd, Avon, OH 44011
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL