CMS Price Transparency Data

Ultrasound, pelvis

Facility: UPMC Williamsport

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $582
Cash Discount Price: $732
vs. Medicare Baseline: 5.45x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at UPMC Williamsport is $582. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $732. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.45x the Medicare baseline. Located in 700 High Street, Williamsport, PA.

Cash / Self-Pay

$732

Average discount available for prompt cash payment at this facility.

Insurance Median

$582

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: $732 (685%)

Insurance Median: $582 (545%)

Cash: $732 (685% of Medicare)

Ins. Median: $582 (545% 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 545% of the Medicare baseline (a markup of 445%). 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
UnitedHealthcare	$60 - $834	56%
Geisinger	$84 - $817	79%
Upmc Health Plan	$84 - $532	79%
Amerihealth Caritas	$86 - $104	81%
Blue Cross Blue Shield	$102 - $572	95%
Aetna	$104 - $805	97%
Highmark Wholecare (Prev Gateway)	$107 - $109	100%
Pa Health & Wellness	$109 - $130	102%
Upmc Work Partners	$243	228%
Three Rivers Provider Network	$260 - $1,098	243%
Multiplan	$268 - $952	251%
Coventry/First Health	$611 - $821	572%
Wirerope Works	$678	635%
Cigna	$836	783%
America'S Choice	$976	914%
Intergroup	$976	914%

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 $732.
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 UPMC Williamsport 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.