CMS Price Transparency Data

Ultrasound, pelvis

Facility: Geisinger-Community Medical Center

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $486
Cash Discount Price: $1,390
vs. Medicare Baseline: 4.55x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Geisinger-Community Medical Center is $486. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,390. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.55x the Medicare baseline. Located in 1822 Mulberry Street, Scranton, PA.

Cash / Self-Pay

$1,390

Average discount available for prompt cash payment at this facility.

Insurance Median

$486

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: $1,390 (1301%)

Insurance Median: $486 (455%)

Cash: $1,390 (1301% of Medicare)

Ins. Median: $486 (455% 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 455% of the Medicare baseline (a markup of 355%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Medicaid / KanCare	$76	71%
Geisinger Family Plan	$79	74%
Amerihealth	$88	82%
Upmc For You	$90	84%
Health Partners	$92	86%
Upmc Chip	$96	90%
Geisinger Health Plan	$105 - $302	98%
Medicare (plans)	$105	98%
Prison Health Services	$105	98%
Humana	$107	100%
Aetna	$110 - $1,323	103%
Blue Cross Blue Shield	$175 - $486	164%
Ambetter / Centene	$347	325%
Cigna	$989	926%
Christian Healthcare Ministries	$1,121	1050%
UnitedHealthcare	$1,238	1159%
Healthnet	$1,314	1230%
Universal Managed Care	$1,390 - $1,457	1301%
Intergroup Services	$1,794 - $2,018	1680%
Multiplan	$1,906	1784%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $1,390.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 76856.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Geisinger-Community Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 76856.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.