CMS Price Transparency Data

Ultrasound, pelvis

Facility: Chester County Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $284
  • Cash Discount Price: $970
  • vs. Medicare Baseline: 2.66x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Chester County Hospital is $284. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $970. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.66x the Medicare baseline. Located in 701 East Marshall Street, West Chester, PA.
Cash / Self-Pay
$970

Average discount available for prompt cash payment at this facility.

Insurance Median
$284

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: $970 (908%)
Insurance Median: $284 (266%)
Cash: $970 (908% of Medicare)
Ins. Median: $284 (266% 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 266% of the Medicare baseline (a markup of 166%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Gateway $46 - $133 43%
Medicaid / KanCare $46 - $970 43%
Health Partners $58 - $970 54%
Keystone First $60 56%
UnitedHealthcare $66 - $337 62%
Hospice Vna $107 100%
Medicare (plans) $107 - $110 100%
Primecare Medical $107 100%
Tricare $107 100%
Va Medical Center $107 100%
Cigna $111 - $970 104%
Humana $111 104%
Devoted Health $113 106%
Pa Health And Wellness $113 - $177 106%
Aetna $114 - $344 107%
Clover Health Plan $114 107%
Mva Insurance $118 110%
Keystone First Vip Choice $119 111%
Us Family Health Plan $124 116%
Elap $153 143%
Claims Watcher $172 - $193 161%
Oscar Health Plan $183 171%
Healthamerica/Coventry $187 175%
Centivo $193 181%
Elap Services $200 187%
Highmark $221 207%
Pgm - Regie De L'Assurance Maladie Quebec $223 209%
Todays Option $272 255%
Ibc $284 - $471 266%
Keystone Hmo Proactive $284 266%
Penn Global Medicine $285 267%
Preferred Health Care Eliance $301 282%
Pgm - Kuwait Defense $340 - $436 318%
Geisinger Health Plan $341 319%
Qualcare $369 345%
La Comunidad Hispana $388 363%
Pgm - Chop $388 363%
Pgm - Royal Embassy Of Saudi Arabia $582 545%
Pgm - Embassy Of Qatar $630 590%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $630 590%
Pgm - Embassy Of The United Emirates/Ipc $679 636%
Pgm - Kuwait Health Division $776 727%
Pgm - Kuwait Oil $776 727%
Preferred Health Care $776 727%
Intergroup $824 771%
Olympus $850 796%
International Pfs $970 908%
Medrisk $970 908%
Not Adjusted $970 908%
Workers Compensation $970 908%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 701 East Marshall Street, West Chester, PA 19380
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals