CMS Price Transparency Data

Ultrasound, pelvis

Facility: Mercy Health Rehabilitation Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $901
  • Cash Discount Price: $901
  • vs. Medicare Baseline: 8.44x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Mercy Health Rehabilitation Hospital is $901. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $901. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 8.44x the Medicare baseline. Located in 3180 Belmont Ave, Youngstown, OH.
Cash / Self-Pay
$901

Average discount available for prompt cash payment at this facility.

Insurance Median
$901

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: $901 (844%)
Insurance Median: $901 (844%)
Cash: $901 (844% of Medicare)
Ins. Median: $901 (844% 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 844% of the Medicare baseline (a markup of 744%). 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
Medical Mutual Nas $494 463%
Aultcare $613 574%
Multiplan $757 709%
Aetna $901 844%
Ambetter / Centene $901 844%
Blue Cross Blue Shield $901 844%
Caresource Exchange $901 844%
Cigna $901 844%
Devoted $901 844%
Highmark Ppo Commercial $901 844%
Highmark Ppo Exchange $901 844%
Humana $901 844%
Medicaid / KanCare $901 844%
Medical Mutual Exchange $901 844%
Medical Mutual Medflex $901 844%
Medical Mutual New Biz $901 844%
Medical Mutual Supermed Commercial $901 844%
Medical Mutual Traditional Commercial $901 844%
Medicare (plans) $901 844%
Molina Exchange $901 844%
UnitedHealthcare $901 844%
Upmc $901 844%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3180 Belmont Ave, Youngstown, OH 44505
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL