CMS Price Transparency Data

Ultrasound, pelvis

Facility: Community Hospital, LLC

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $303
  • Cash Discount Price: $302
  • vs. Medicare Baseline: 2.84x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Community Hospital, LLC is $303. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $302. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.84x the Medicare baseline. Located in 3100 Southwest 89Th Street, Oklahoma City, OK.
Cash / Self-Pay
$302

Average discount available for prompt cash payment at this facility.

Insurance Median
$303

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: $302 (283%)
Insurance Median: $303 (284%)
Cash: $302 (283% of Medicare)
Ins. Median: $303 (284% 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 284% of the Medicare baseline (a markup of 184%). 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
UnitedHealthcare $157 147%
Blue Cross Blue Shield $170 159%
Healthchoice $213 199%
Aetna $233 - $427 218%
Cigna $304 - $384 285%
First Health $498 466%
Medica $692 648%
Global Health $826 773%
Community Care $961 900%
Healthcare Highways $961 900%
Humana $1,153 1079%
Phcs $1,345 1259%
Preferred Community Choice $1,345 1259%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3100 Southwest 89Th Street, Oklahoma City, OK 73159
  • CMS Rating: ★★★★☆
  • Ownership Type: Physician
  • Hospital Type: Acute Care Hospitals