CMS Price Transparency Data

Ultrasound, pelvis

Facility: HCA Houston Healthcare Kingwood

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $622
  • Cash Discount Price: $5,512
  • vs. Medicare Baseline: 5.82x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at HCA Houston Healthcare Kingwood is $622. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,512. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.82x the Medicare baseline. Located in 22999 Us Hwy 59, Kingwood, TX.
Cash / Self-Pay
$5,512

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: $5,512 (5161%)
Insurance Median: $622 (582%)
Cash: $5,512 (5161% 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.

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 - $915 90%
United $98 - $2,481 92%
Aetna $104 - $790 97%
Molina Healthcare $106 99%
Humana $120 - $1,759 112%
Blue Cross Blue Shield $197 - $1,929 184%
Healthcare Highways $213 199%
Texas Athletic Network $300 - $600 281%
Superior Health Plan $331 310%
Evry Health $1,505 1409%
Imagine Health $1,929 1806%
Kelsey Care (Boon-Chapman) $1,929 1806%
Christus (Usfhp) $2,205 2064%
Curative Administrators $2,205 2064%
Healthsmart Preferred Care $2,370 - $4,686 2219%
Averde Health $2,481 2323%
Fidelis Securecare Of Tx $2,481 2323%
Coventry National First Health $2,938 2751%
Physicians Cooperative Of Texas $3,032 2839%
Rockport Workers Comp $3,032 2839%
Independent Medical System $3,307 3096%
National Healthcare Solutions $3,307 3096%
Southwest Medical $3,307 3096%
Coastal Comp $3,583 3355%
Multiplan $4,134 - $4,686 3870%
Physicians, Inc $4,686 4387%
Usa Managed Care $4,686 4387%
Affiliated Ppo $4,961 4645%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 22999 Us Hwy 59, Kingwood, TX 77325
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals