CMS Price Transparency Data

Ultrasound, pelvis

Facility: Lehigh Valley Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $118
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.10x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Lehigh Valley Hospital is $118. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.10x the Medicare baseline. Located in 1200 South Cedar Crest Boulevard, Allentown, PA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$118

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%)
Insurance Median: $118 (110%)
Ins. Median: $118 (110% 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
Amerihealth Caritas $51 - $138 48%
UnitedHealthcare $57 - $377 53%
Geisinger $58 - $488 54%
Highmark Wholecare/Gateway $59 - $97 55%
Jefferson Health Partners $63 - $222 59%
Pa Health & Wellness $63 - $103 59%
Aetna $67 - $615 63%
Keystone First $67 - $111 63%
Upmc $77 - $540 72%
Cigna $94 88%
Amerihealth $111 - $114 104%
Blue Cross Blue Shield $111 - $466 104%
Ibc $111 - $580 104%
Highmark Blue Shield $113 - $359 106%
Devoted Health $118 110%
Humana $118 110%
Gateway $119 111%
Emblem $120 - $495 112%
Pa Health & Wellness (Allwell) $122 114%
Ambetter / Centene $336 315%
Valley Preferred $647 606%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1200 South Cedar Crest Boulevard, Allentown, PA 18103
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals