CMS Price Transparency Data

Ultrasound, pelvis

Facility: HCA Houston Healthcare West

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $622
  • Cash Discount Price: $4,198
  • vs. Medicare Baseline: 5.82x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at HCA Houston Healthcare West is $622. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,198. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.82x the Medicare baseline. Located in 12141 Richmond Ave, Houston, TX.
Cash / Self-Pay
$4,198

Average discount available for prompt cash payment at this facility.

Insurance Median
$622

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: $4,198 (3930%)
Insurance Median: $622 (582%)
Cash: $4,198 (3930% of Medicare)
Ins. Median: $622 (582% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 582% of the Medicare baseline (a markup of 482%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Texas Health Network $94 88%
Amerigroup $96 90%
Community Health Choice Mcd $96 90%
Texas Childrens Health Plans $96 - $697 90%
United $98 - $1,889 92%
Aetna $104 - $790 97%
Molina Healthcare $106 99%
Humana $120 - $1,341 112%
Blue Cross Blue Shield $197 - $1,469 184%
Healthcare Highways $213 199%
Superior Health Plan $252 236%
Texas Athletic Network $300 - $600 281%
Texas Workforce Commission $1,008 944%
Evry Health $1,146 1073%
Imagine Health $1,469 1375%
Christus (Usfhp) $1,679 1572%
Curative Administrators $1,679 1572%
Healthsmart Preferred Care $1,805 - $3,568 1690%
Averde Health $1,889 1769%
Fidelis Securecare Of Tx $1,889 1769%
Coventry National First Health $2,238 2095%
Physicians Cooperative Of Texas $2,309 2162%
Rockport Workers Comp $2,309 2162%
Independent Medical System $2,519 2358%
National Healthcare Solutions $2,519 2358%
Southwest Medical $2,519 2358%
Triumph $2,519 2358%
Coastal Comp $2,729 2555%
Multiplan $3,148 - $3,568 2947%
Cigna $3,358 3144%
Physicians, Inc $3,568 3341%
Affiliated Ppo $3,778 3537%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12141 Richmond Ave, Houston, TX 77082
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals