CMS Price Transparency Data

Ultrasound, pelvis

Facility: Womans Hospital of Texas,The

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $560
  • Cash Discount Price: $2,303
  • vs. Medicare Baseline: 5.24x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Womans Hospital of Texas,The is $560. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,303. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.24x the Medicare baseline. Located in 7600 Fannin, Houston, TX.
Cash / Self-Pay
$2,303

Average discount available for prompt cash payment at this facility.

Insurance Median
$560

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: $2,303 (2156%)
Insurance Median: $560 (524%)
Cash: $2,303 (2156% of Medicare)
Ins. Median: $560 (524% 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 524% of the Medicare baseline (a markup of 424%). 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.

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
Texas Health Network $94 88%
Amerigroup $96 90%
Community Health Choice Mcd $96 90%
Texas Childrens Health Plans $96 - $601 90%
United $98 - $1,036 92%
Aetna $104 - $811 97%
Molina Healthcare $106 99%
Humana $120 - $1,341 112%
Superior Health Plan $138 129%
Blue Cross Blue Shield $197 - $806 184%
Healthcare Highways $213 199%
Texas Athletic Network $300 - $600 281%
Evry Health $629 589%
Imagine Health $806 755%
Kelsey Care (Boon-Chapman) $806 755%
Christus (Usfhp) $921 862%
Curative Administrators $921 862%
Healthsmart Preferred Care $990 - $1,958 927%
Averde Health $1,036 970%
Fidelis Securecare Of Tx $1,036 970%
Coventry National First Health $1,228 1150%
Physicians Cooperative Of Texas $1,267 1186%
Rockport Workers Comp $1,267 1186%
Independent Medical System $1,382 1294%
National Healthcare Solutions $1,382 1294%
Southwest Medical $1,382 1294%
Coastal Comp $1,497 1402%
Affiliated Ppo $1,727 1617%
Fiesta Mart, Inc $1,727 1617%
Multiplan $1,727 - $1,958 1617%
Physicians, Inc $1,958 1833%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7600 Fannin, Houston, TX 77054
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals