CMS Price Transparency Data
Ultrasound, pelvis
Facility: Hospital of Univ of Pennsylvania
Billing Code: 76856 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 76856
- Insurance Median: $206
- Cash Discount Price: $1,401
- vs. Medicare Baseline: 1.93x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Hospital of Univ of Pennsylvania is $206. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,401. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.93x the Medicare baseline. Located in 3400 Spruce St, Philadelphia, PA.
Cash / Self-Pay
$1,401
Average discount available for prompt cash payment at this facility.
Insurance Median
$206
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: $1,401 (1312%)
Insurance Median: $206 (193%)
Cash: $1,401 (1312% of Medicare)
Ins. Median: $206 (193% 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 |
|---|---|---|
| Paired Kidney Exchange | $21 - $203 | 20% |
| Horizon Nj Health | $44 - $447 | 41% |
| Medicaid / KanCare | $46 - $2,543 | 43% |
| Kaiser Permanente | $49 - $2,543 | 46% |
| Gspp And Wissahickon Hospice | $55 | 51% |
| Preferred Health Care Eliance | $57 - $559 | 53% |
| Health Partners | $58 - $2,543 | 54% |
| Pgm - Regie De L'Assurance Maladie Quebec | $59 - $585 | 55% |
| Keystone Mercy Health Plan | $60 - $2,543 | 56% |
| Upmc | $69 - $2,543 | 65% |
| Pa Medical Assistance | $76 - $2,543 | 71% |
| Pgm - Kuwait Defense | $90 - $1,144 | 84% |
| UnitedHealthcare | $92 - $2,543 | 86% |
| Qualcare | $98 - $966 | 92% |
| Olympus | $101 - $999 | 95% |
| Blue Cross Blue Shield | $102 - $1,287 | 95% |
| Keystone Hmo Proactive | $102 | 95% |
| Coventry | $103 - $1,297 | 96% |
| Pgm - Chop | $103 - $1,017 | 96% |
| Wissahickon Hospice | $103 - $1,017 | 96% |
| Ibc Commercial Hpn | $106 | 99% |
| Medicare (plans) | $110 - $112 | 103% |
| Philadelphia Va Medical Center | $110 | 103% |
| Tricare | $110 | 103% |
| Ibc | $112 | 105% |
| Cigna | $113 - $1,144 | 106% |
| Geisinger Health Plan | $113 - $349 | 106% |
| Humana | $113 - $2,034 | 106% |
| Devoted Health | $115 | 108% |
| Pa Health And Wellness | $115 - $181 | 108% |
| Penn Life (Living Independently For Elders) | $115 | 108% |
| Aetna | $116 - $2,543 | 109% |
| Healthamerica/Coventry | $116 - $1,246 | 109% |
| Clover Health Plan | $119 | 111% |
| Keystone First | $122 | 114% |
| Us Family Health Plan | $126 | 118% |
| First Health Global | $129 - $1,272 | 121% |
| Gateway Health Plan | $136 | 127% |
| Health Net | $155 - $1,526 | 145% |
| Pgm - Royal Embassy Of Saudi Arabia | $155 - $1,526 | 145% |
| Elap | $156 | 146% |
| Pgm - Embassy Of Qatar | $168 - $1,653 | 157% |
| Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) | $168 - $1,653 | 157% |
| Interlink | $173 - $1,704 | 162% |
| Claims Watcher | $176 - $198 | 165% |
| Pgm - Embassy Of The United Emirates/Ipc | $181 - $1,780 | 169% |
| Oscar Health Plan | $187 | 175% |
| Centivo | $198 | 185% |
| Elap Services | $204 | 191% |
| Health America/Ccn | $206 - $2,034 | 193% |
| Intergroup | $206 - $2,034 | 193% |
| Pgm - Kuwait Health Division | $206 - $2,034 | 193% |
| Pgm - Kuwait Oil | $206 - $2,034 | 193% |
| Preferred Care | $206 - $2,034 | 193% |
| Highmark | $231 | 216% |
| Blue Quality Centers For Transplant (Bqct) | $258 - $2,543 | 242% |
| City Of Philadelphia Behavioral Health | $258 - $2,543 | 242% |
| Commercial Other | $258 - $2,543 | 242% |
| International Pfs | $258 - $2,543 | 242% |
| United Behavioral Health | $258 - $2,543 | 242% |
| Workers Compensation | $258 - $2,543 | 242% |
| Penn Global Medicine | $291 | 272% |