CMS Price Transparency Data

Ultrasound, pelvis

Facility: Hospital San Francisco

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $57
  • Cash Discount Price: $75
  • vs. Medicare Baseline: 0.53x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Hospital San Francisco is $57. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $75. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.53x the Medicare baseline. Located in 371 De Diego Ave, San Juan, PR.
Cash / Self-Pay
$75

Average discount available for prompt cash payment at this facility.

Insurance Median
$57

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: $75 (70%)
Insurance Median: $57 (53%)
Cash: $75 (70% of Medicare)
Ins. Median: $57 (53% 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
First Medical $30 - $38 28%
Triple S $32 - $75 30%
Mc $35 33%
Mso $35 - $56 33%
Humana $40 - $56 37%
Mcs $42 - $57 39%
Aarp $47 44%
Privado $48 45%
Western Medical Hospice $48 45%
Mapfre $50 47%
Medicare (plans) $56 52%
Tricare $56 52%
Fondo Del Seguro Estado $57 53%
Comerciales $61 57%
Cigna $62 58%
Medicaid / KanCare $62 58%
Prossam $62 58%
Va $62 58%
Pr Other Insurances $63 59%
Bl $66 62%
Acaa $68 64%
Corvel Network $75 70%
Mpc-Pr Other Insurances $75 70%
Plan De Salud Menonita $75 - $80 70%
Ch $77 72%
Mpc - Us $77 72%
UnitedHealthcare $77 72%
Us $77 72%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 371 De Diego Ave, San Juan, PR 00923
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals