Ultrasound, pelvis
Facility: Methodist Hospital Stone Oak
Billing Code: 76856 (CPT)
- CPT Billing Code: 76856
- Insurance Median: $428
- Cash Discount Price: $3,060
- vs. Medicare Baseline: 4.01x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 401% of the Medicare baseline (a markup of 301%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Amerigroup | $96 - $428 | 90% |
| Community First Health Plans | $96 - $826 | 90% |
| United | $96 - $1,377 | 90% |
| Usa Managed Care Chip | $96 | 90% |
| Aetna | $104 - $1,530 | 97% |
| Molina Healthcare | $106 | 99% |
| Humana | $120 | 112% |
| Superior Health | $153 | 143% |
| Blue Cross Blue Shield | $196 - $903 | 184% |
| Imperial Insurance | $581 | 544% |
| Focus Health Solutions | $918 | 859% |
| Healthcare Highways | $943 | 883% |
| Valenz | $1,071 | 1003% |
| Evry Health | $1,126 | 1054% |
| Curative Administrators | $1,224 | 1146% |
| Fidelis Securecare | $1,377 | 1289% |
| National Choicecare | $1,530 | 1432% |
| Texas Healthcare Foundation Heb | $1,530 | 1432% |
| Tx Healthcare Foundation | $1,530 | 1432% |
| Healthsmart Preferred Care | $1,683 | 1576% |
| Independent Medical Systems | $1,683 | 1576% |
| Physician Cooperative Of Texas | $1,683 | 1576% |
| Haa Preferred Partners | $1,836 | 1719% |
| San Antonio Employers Health Alliance | $1,836 | 1719% |
| Coastal Comp Health Networks | $1,989 | 1862% |
| National Healthcare Solutions | $1,989 | 1862% |
| Tml Intergovernmental Ebp | $2,142 | 2005% |
| Multiplan | $2,295 - $2,601 | 2149% |
| Triwest Health Alliance | $2,295 | 2149% |
| Usa Managed Care | $2,295 | 2149% |
| Blue Bell | $2,448 | 2292% |
| Directcare America | $2,448 | 2292% |
| Managed Healthcare | $2,601 | 2435% |