CMS Price Transparency Data

Ultrasound, pelvis

Facility: Cincinnati Children's Hospital Medical Center

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $138
  • Cash Discount Price: $247
  • vs. Medicare Baseline: 1.29x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Cincinnati Children's Hospital Medical Center is $138. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $247. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.29x the Medicare baseline. Located in 3333 Burnet Avenue, Cincinnati, OH.
Cash / Self-Pay
$247

Average discount available for prompt cash payment at this facility.

Insurance Median
$138

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: $247 (231%)
Insurance Median: $138 (129%)
Cash: $247 (231% of Medicare)
Ins. Median: $138 (129% 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.

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 $22 - $788 21%
Mhs_In $22 - $82 21%
Aetna $23 - $762 22%
Caresource_In $23 - $86 22%
Passport_Ky $23 - $209 22%
Humana $24 - $235 22%
United_Health_Care_Ky $24 - $212 22%
Wellcare_Ky $24 - $211 22%
Caresource_Oh $38 - $224 36%
Amerihealth_Caritas_Oh $39 - $242 37%
Molina_Oh $40 - $247 37%
Buckeye_Oh $42 - $258 39%
United_Health_Care_Oh $46 - $237 43%
Caresource_Oh_Insurance $79 - $385 74%
Medical_Mutual_Of_Ohio_Insurance $88 - $762 82%
Parkview_Signature_Care_Insurance $101 - $626 95%
Point_Comfort_Insurance $107 - $521 100%
Margaret_Mary_Health_Insurance $109 - $626 102%
United_Health_Care_Insurance $126 - $719 118%
Beechstreet_Insurance $133 - $786 125%
Cigna $133 - $762 125%
Health_Ohio_Network_Insurance $150 - $762 140%
Custom_Design_Benefits_Insurance $157 - $762 147%
Health_Smart_Preferred_Insurance $157 - $762 147%
Medical_Benefit_Administrators_Insurance $157 - $762 147%
Ohio_Health_Choice_Insurance $157 - $762 147%
Private_Health_Care_Systems_Insurance $158 - $770 148%
First_Health_Group_Insurance $162 - $786 152%
Health_Link_Insurance $162 - $786 152%
Evolutions_Health_Care_Systems $165 - $802 154%
Galaxy_Health_Insurance $165 - $802 154%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3333 Burnet Avenue, Cincinnati, OH 45229
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens