CMS Price Transparency Data
Ultrasound, pelvis
Facility: Saint Alphonsus Medical Center Ontario
Billing Code: 76856 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 76856
- Insurance Median: $212
- Cash Discount Price: $459
- vs. Medicare Baseline: 1.98x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Saint Alphonsus Medical Center Ontario is $212. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $459. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.98x the Medicare baseline. Located in 351 Sw 9Th Street, Ontario, OR.
Cash / Self-Pay
$459
Average discount available for prompt cash payment at this facility.
Insurance Median
$212
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: $459 (430%)
Insurance Median: $212 (198%)
Cash: $459 (430% of Medicare)
Ins. Median: $212 (198% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medicaid / KanCare | $81 - $212 | 76% |
| Blue Cross Blue Shield | $122 - $600 | 114% |
| Medicare (plans) | $122 - $131 | 114% |
| UnitedHealthcare | $122 - $678 | 114% |
| Aetna | $126 - $669 | 118% |
| American Health Advantage Of Idaho | $127 | 119% |
| Ada County Jail Inmate Ins | $212 | 198% |
| Ambetter / Centene | $212 | 198% |
| Amish Mennonite | $212 | 198% |
| Bcccp-Michigan | $212 | 198% |
| Bccp | $212 | 198% |
| Bmc Healthnet | $212 | 198% |
| Breast Grant-Connecticut | $212 | 198% |
| California Health And Wellness | $212 | 198% |
| Cardinal Innovations Lme | $212 | 198% |
| Care Oregon Ohp | $212 | 198% |
| Cencal Health Plan | $212 | 198% |
| Cenpatico | $212 | 198% |
| Centurion Of Idaho | $212 | 198% |
| Chhuny | $212 | 198% |
| Childrens Comm Health Plan | $212 | 198% |
| Childrens Medical Services Title 19 | $212 | 198% |
| Cigna | $212 - $664 | 198% |
| Community Benefit Health | $212 | 198% |
| Community Care Behavorial Health | $212 | 198% |
| Community Health Choice | $212 | 198% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund | $212 | 198% |
| Dean Wi Badgercare | $212 | 198% |
| Delaware First Health | $212 | 198% |
| Delta Dental Nj | $212 | 198% |
| Dph Tb Program | $212 | 198% |
| Dscc | $212 | 198% |
| Eastpointe Lme | $212 | 198% |
| Family Health Network | $212 | 198% |
| Freedom First Healthcare | $212 | 198% |
| Ghc Scw Wi Badgercare | $212 | 198% |
| Harbor Health | $212 | 198% |
| Health Safety Net | $212 | 198% |
| Healthy Blue Ne | $212 | 198% |
| Hennepin Health | $212 | 198% |
| Humana | $212 - $621 | 198% |
| Id County Ada | $212 | 198% |
| Id County Canyon | $212 | 198% |
| Id County Cat Fund | $212 | 198% |
| Id County Payette | $212 | 198% |
| Idaho Womens Health Check | $212 | 198% |
| Indiana Breast Cervical Cancer | $212 | 198% |
| Inland Empire Health Plan | $212 | 198% |
| Intercommunity Health Ohp | $212 | 198% |
| Iowa Total Care | $212 | 198% |
| Jai Medical System | $212 | 198% |
| Kern Family Health Plan | $212 | 198% |
| Keystone First | $212 | 198% |
| Keystone First Chip | $212 | 198% |
| La Care Health Plan | $212 | 198% |
| Lakeland Care Inc | $212 | 198% |
| Managed Health Services - Indiana | $212 | 198% |
| Maryland Breast & Cervical Program | $212 | 198% |
| Maryland Healthy Smiles - Scion Dental | $212 | 198% |
| Maryland Physicians Care | $212 | 198% |
| Massachusetts Behavioral Health Partnership | $212 | 198% |
| Mdwise | $212 | 198% |
| Medi-Cal | $212 | 198% |
| Medi-Cal Healthnet | $212 | 198% |
| Medstar Dc Healthy Family | $212 | 198% |
| Medstar Md Health Choice | $212 | 198% |
| Mo Home State Health Plan | $212 | 198% |
| Molina Centennial Care | $212 | 198% |
| Nascentia Health Options | $212 | 198% |
| Nebraska Total Care | $212 | 198% |
| New York Cancer Services Program | $212 | 198% |
| Nextlevel Health | $212 | 198% |
| Oregon Screenwise | $212 | 198% |
| Pace Of Southwest Michigan | $212 | 198% |
| Paramount Advantage | $212 | 198% |
| Parkland Community Health Plan | $212 | 198% |
| Partners Behavioral Lme | $212 | 198% |
| Peach State Healthplan | $212 | 198% |
| Presbyterian Centennial Care | $212 | 198% |
| Prestige Health Choice | $212 | 198% |
| Priority Partners | $212 | 198% |
| Rx 340B Pass Along | $212 | 198% |
| Rx Assistance/Rx Manufacturer Assistance 0 Copay | $212 | 198% |
| Rx Medi-Cal | $212 | 198% |
| Rx Meridian Rx | $212 | 198% |
| Sandhills Center Lme | $212 | 198% |
| Screening For Life | $212 | 198% |
| Sunshine State Health Plan | $212 | 198% |
| Superior Health | $212 | 198% |
| Tenncare | $212 | 198% |
| Texas Children'S Health Plan | $212 | 198% |
| Trillium Community Ohp | $212 | 198% |
| Tufts Health Public Plans | $212 | 198% |
| Vaya Health Lme | $212 | 198% |
| Wellsense Health Plan | $212 | 198% |
| Wi Womens Wellness | $212 | 198% |
| Pacificsource Health Plans | $231 - $664 | 216% |
| Moda Health | $242 - $685 | 227% |
| Selecthealth | $306 - $635 | 286% |
| Blue Benefit Administrators Of Massachusetts | $312 | 292% |
| Blue Care Network | $312 | 292% |
| Blue Distinction Transplant | $312 | 292% |
| Blue Shield - Ca | $312 | 292% |
| Blue Shield - Id (Regence) | $312 | 292% |
| Blue Shield - Ny Highmark Northeastern | $312 | 292% |
| Blue Shield - Ny Highmark Western | $312 | 292% |
| Blue Shield - Pa (Highmark) | $312 | 292% |
| Blue Shield - Wa (Regence) | $312 | 292% |
| Healthcare Management Admin | $321 | 301% |
| Webtpa | $329 - $635 | 308% |
| Mountain Health Co-Op | $424 | 397% |
| Allegiance | $537 | 503% |
| Correctional Health Partners | $551 | 516% |
| Columbia Health Network | $565 | 529% |
| Healthnet | $593 | 555% |
| Allied National Global Care | $635 | 595% |
| Asrm - Reliance Standard Life Insurance | $635 | 595% |
| Christian Care Ministry | $635 | 595% |
| Dean Health | $635 | 595% |
| Fallon Health | $635 | 595% |
| Family Life Insurance Company | $635 | 595% |
| First Choice Health | $635 | 595% |
| Ghc Scw | $635 | 595% |
| International Benefit Administrators | $635 | 595% |
| Lifetime Benefit Solutions | $635 | 595% |
| Manhattan Life | $635 | 595% |
| Pai | $635 | 595% |
| Pan-American Life | $635 | 595% |
| Paramount Hmo | $635 | 595% |
| Phcs | $635 | 595% |
| Trinity Health Share | $635 | 595% |
| Lifewise | $657 | 615% |
| Priority Health | $664 | 622% |
| Allied Benefit Systems | $669 | 626% |
| Ameriben | $669 | 626% |
| Asr Health Benefits | $669 | 626% |
| Christian Brother Services | $669 | 626% |
| Geha | $669 - $678 | 626% |
| Healthez | $669 | 626% |
| Luminare Health (Detroit) | $669 | 626% |
| Rural Carrier Health Benefit Plan | $669 | 626% |
| First Health | $671 | 628% |
| Medi Share | $671 | 628% |
| Providence | $671 | 628% |