CMS Price Transparency Data

Ultrasound, pelvis

Facility: Cook Childrens Medical Center

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $419
Cash Discount Price: $713
vs. Medicare Baseline: 3.92x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Cook Childrens Medical Center is $419. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $713. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.92x the Medicare baseline. Located in 801 Seventh Avenue, Fort Worth, TX.

Cash / Self-Pay

$713

Average discount available for prompt cash payment at this facility.

Insurance Median

$419

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: $713 (668%)

Insurance Median: $419 (392%)

Cash: $713 (668% of Medicare)

Ins. Median: $419 (392% 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 392% of the Medicare baseline (a markup of 292%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

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

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Beacon	$228	213%
Firstcare	$228 - $761	213%
Health Plan W/O Uhrip	$228	213%
Rightcare	$318	298%
Molina	$352	330%
Health Plan W. Uhrip	$362	339%
El Paso Health First	$419	392%
Tx Children Health	$419	392%
Aetna	$476	446%
UnitedHealthcare	$552 - $809	517%
Blue Cross Blue Shield	$723 - $799	677%
S&W Health	$799	748%
Cigna	$809	757%
Healthscope	$809	757%
Imagine Health	$809	757%
Humana	$828 - $837	775%
Multiplan	$828	775%
First Health	$837	784%
Galaxy Health	$856	801%
Usamco	$875	819%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $713.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 76856.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Cook Childrens Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 76856.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.