CMS Price Transparency Data

Ultrasound, pelvis

Facility: Grove City Medical Center

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $91
Cash Discount Price: $584
vs. Medicare Baseline: 0.85x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Grove City Medical Center is $91. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $584. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.85x the Medicare baseline. Located in 631 North Broad Street Ext., Grove City, PA.

Cash / Self-Pay

$584

Average discount available for prompt cash payment at this facility.

Insurance Median

$91

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: $584 (547%)

Insurance Median: $91 (85%)

Cash: $584 (547% of Medicare)

Ins. Median: $91 (85% 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.

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
Univera	$27 - $124	25%
Amerihealth	$32 - $126	30%
Highmark	$37 - $211	35%
Pennsylvania Health And Wellness	$40 - $115	37%
Geisinger	$44 - $122	41%
UnitedHealthcare	$44 - $310	41%
Aetna	$46 - $218	43%
Cigna	$52 - $239	49%
University Of Pittsburgh Medical Center	$53 - $184	50%
Highmark Wholecare	$64 - $108	60%
American Health Plans	$102	95%
Life Pittsburgh	$102	95%
Medicare (plans)	$105	98%
Humana	$108	101%
Molina	$112	105%
Martin'S Point	$213	199%
Medical Mutual	$291	272%

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 $584.
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 Grove City 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.