CMS Price Transparency Data

Ultrasound, pelvis

Facility: Christus Santa Rosa Hospital-San Marcos

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $140
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.31x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Christus Santa Rosa Hospital-San Marcos is $140. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.31x the Medicare baseline. Located in 1301 Wonder World Drive, San Marcos, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$140

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%)
Insurance Median: $140 (131%)
Ins. Median: $140 (131% 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
UnitedHealthcare $96 - $1,408 90%
Allwell $103 96%
Christus Health $103 - $144 96%
Humana $103 - $451 96%
Triwest $103 96%
Washington National $103 96%
Wellcare $103 96%
Aetna $105 98%
Cigna $106 - $284 99%
Provider Partners Health Plan $106 99%
Shared Health Insurance Company $108 101%
Amerigroup $111 - $144 104%
Devoted Health Plan $111 104%
Community First $137 128%
Blue Cross Blue Shield $140 - $471 131%
Texas Childrens Health Plan $144 135%
Superior $158 148%
Sendero $176 165%
Naphcare Inc. $206 193%
Healthcare Highways $261 244%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1301 Wonder World Drive, San Marcos, TX 78666
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals