CMS Price Transparency Data

Ultrasound, pelvis

Facility: Medical City Fort Worth

Billing Code: 76856 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$119

about 1.1× the $107 Medicare rate · typically $103–$151

modeled estimate · not a bill or quote

What this hospital charges insurers

$120

About the fair price

about $1 over the fair price · 1.1× Medicare

Medicare pays $107 Fair price $119 This hospital $120 Cash price $1,764 Hospital's list price $1,764

How we calculate the fair BaseRate →

How this hospital compares to other TX hospitals

Highest price of the 9 TX hospitals we have prices for — worth calling around.

Cheapest $32 Priciest $120

Black dot = this hospital, among the 9 TX hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Ultrasound, pelvis is about $119 (about 1.1× the $107 Medicare rate). Medical City Fort Worth charges insurers about $120, or about $1,764 in cash — about the fair price. Located in Fort Worth, TX.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$96 - $1,517	90%
Blue Cross Blue Shieldmajor	$133 - $783	125%
Aetnamajor	$104 - $1,039	97%
Cignamajor	$101 - $935	95%
Humanamajor	$120 - $547	112%
Amerigroup	$96	90%
Cigna HealthSpring	$101	95%
Fidelis Care	$794	743%
Health Net	$1,235	1156%
Healthcare Highways	$432 - $596	404%
Molina	$106 - $108	99%
UniCare	$388 - $1,764	363%
+ 15 smaller / regional plans	$96 - $1,764

Government programs also on file: Medicaid.

Excludes 5 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 1,764), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 76856.

Insurance Before you use insurance

Call your insurance company to confirm Medical City Fort Worth is in-network.
Ask your insurer whether prior approval is required for CPT code 76856.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Medical City Fort Worth

Compare: Ultrasound, pelvis at other TX hospitals

Insurance negotiated median for the same procedure, sorted lowest first.