CMS Price Transparency Data

Ultrasound, pelvis

Facility: Hospital Pavia Arecibo

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $47
  • Cash Discount Price: $45
  • vs. Medicare Baseline: 0.44x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Hospital Pavia Arecibo is $47. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $45. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.44x the Medicare baseline. Located in Carretera 129 Km.1 Avenida San Luis, Arecibo, PR.
Cash / Self-Pay
$45

Average discount available for prompt cash payment at this facility.

Insurance Median
$47

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: $45 (42%)
Insurance Median: $47 (44%)
Cash: $45 (42% of Medicare)
Ins. Median: $47 (44% 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
Fondo Del Seguro Estado $18 17%
Mso $25 - $49 23%
Medicare (plans) $34 32%
Plan De Salud Menonita $37 - $38 35%
Bl $38 36%
First Medical $38 - $44 36%
Mapfre $38 36%
Plan Auxilio Mutuo $38 36%
Triple S $38 - $77 36%
Cigna $40 37%
Mcs $44 - $77 41%
Prossam $47 44%
Privado $48 45%
Acaa $49 46%
Humana $51 - $77 48%
Comerciales $54 51%
Mc $54 51%
Hospicio $57 53%
Auxilio Platino $69 65%
Aarp $75 70%
Ch $77 72%
Tricare $77 72%
Va $77 72%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: Carretera 129 Km.1 Avenida San Luis, Arecibo, PR 00612
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals