CMS Price Transparency Data

Ultrasound, pelvis

Facility: Hospital Pavia Hato Rey, Inc

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $41
  • Cash Discount Price: $169
  • vs. Medicare Baseline: 0.38x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Hospital Pavia Hato Rey, Inc is $41. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $169. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.38x the Medicare baseline. Located in Ave Ponce De Leon 435, Hato Rey, PR.
Cash / Self-Pay
$169

Average discount available for prompt cash payment at this facility.

Insurance Median
$41

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: $169 (158%)
Insurance Median: $41 (38%)
Cash: $169 (158% of Medicare)
Ins. Median: $41 (38% 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
Auxilio Salud Plus $19 18%
Plan Socios Auxilio $19 18%
Acaa $24 22%
Tricare $30 28%
Humana $33 - $47 31%
Mc $35 33%
Triple S $36 - $78 34%
Bl $38 36%
Mapfre $38 36%
Mcs $38 36%
Plan De Salud Menonita $38 - $43 36%
First Medical $39 - $48 37%
Corvel Network $41 38%
Prossam $41 38%
Cigna $42 39%
Mso $43 - $77 40%
Privado $55 51%
Fondo Del Seguro Estado $59 55%
Bella Vista $60 56%
Ch $71 66%
Aarp $75 70%
Va $77 72%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: Ave Ponce De Leon 435, Hato Rey, PR 00919
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals