CMS Price Transparency Data

Ultrasound, pelvis

Facility: Geisinger Jersey Shore Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $173
Cash Discount Price: $479
vs. Medicare Baseline: 1.62x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Geisinger Jersey Shore Hospital is $173. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $479. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.62x the Medicare baseline. Located in 1020 Thompson Street, Jersey Shore, PA.

Cash / Self-Pay

$479

Average discount available for prompt cash payment at this facility.

Insurance Median

$173

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: $479 (448%)

Insurance Median: $173 (162%)

Cash: $479 (448% of Medicare)

Ins. Median: $173 (162% 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
Advantra	$43	40%
Aetna	$43 - $323	40%
American Progressive	$43	40%
Blue Cross Blue Shield	$43 - $459	40%
Humana	$43	40%
Medicare (plans)	$43	40%
Medicaid / KanCare	$76	71%
Amerihealth	$84	79%
Geisinger Family Plan	$84	79%
Upmc For You	$90	84%
Health Partners	$92	86%
Upmc Chip	$96	90%
Cigna	$100	94%
Ambetter / Centene	$102	95%
Prison Health Services	$126	118%
Geisinger Health Plan	$155 - $379	145%
UnitedHealthcare	$343	321%
Christian Healthcare Ministries	$386	361%
Medical Development International	$541	507%
Integrated Health Plan	$580	543%
Prime Health Services	$580	543%
Multiplan	$618	579%

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 $479.
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 Geisinger Jersey Shore Hospital 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.