CMS Price Transparency Data

Ultrasound, pelvis

Facility: The Hospital at Westlake Medical Center

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $98
  • Cash Discount Price: $219
  • vs. Medicare Baseline: 0.92x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at The Hospital at Westlake Medical Center is $98. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $219. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.92x the Medicare baseline. Located in 5656 Bee Caves Road, Suite M-302, Austin, TX.
Cash / Self-Pay
$219

Average discount available for prompt cash payment at this facility.

Insurance Median
$98

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: $219 (205%)
Insurance Median: $98 (92%)
Cash: $219 (205% of Medicare)
Ins. Median: $98 (92% 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.

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
Blue Cross Blue Shield $96 - $114 90%
Medicaid / KanCare $96 90%
Superior_Mcd $96 90%
Aetna $98 - $111 92%
Ambetter / Centene $98 92%
Edhp $98 92%
Humana $98 - $442 92%
Mcr_United $98 92%
Medicare (plans) $98 92%
Sendero $98 92%
Tricare $98 92%
Triwest $98 92%
Wellcare $98 92%
90_Degree_Benefits $148 139%
Cigna $198 185%
United_Healthcare $408 382%
Multiplan $442 414%
Beech_Street $476 446%
Scott_And_White $559 523%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5656 Bee Caves Road, Suite M-302, Austin, TX 78746
  • CMS Rating: No CMS Rating
  • Ownership Type: Physician
  • Hospital Type: Acute Care Hospitals