CMS Price Transparency Data

Ultrasound, pelvis

Facility: CHI St Lukes Lakeside Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $302
  • Cash Discount Price: $990
  • vs. Medicare Baseline: 2.83x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at CHI St Lukes Lakeside Hospital is $302. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $990. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.83x the Medicare baseline. Located in 17400 St Lukes Way, The Woodlands, TX.
Cash / Self-Pay
$990

Average discount available for prompt cash payment at this facility.

Insurance Median
$302

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: $990 (927%)
Insurance Median: $302 (283%)
Cash: $990 (927% of Medicare)
Ins. Median: $302 (283% 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 283% of the Medicare baseline (a markup of 183%). 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
Renaissance $77 72%
Wellpoint $96 - $160 90%
United $98 - $1,329 92%
UnitedHealthcare $98 - $2,336 92%
Blue Cross Blue Shield $101 - $378 95%
Cigna $107 - $1,980 100%
Humana $107 - $1,838 100%
Kelsey $107 100%
Selectcare $107 100%
Aetna $109 - $1,923 102%
Amerivantage $110 103%
Chc $111 - $1,555 104%
Devoted $114 107%
Scanhealth $114 107%
Kindred $117 110%
Kelseycare $144 135%
Ambetter / Centene $160 150%
Community Health Choice $160 150%
Harris Health $160 150%
Bright Health $182 170%
Tchp $226 - $303 212%
Nx Health $346 324%
Tchpchip $990 - $1,244 927%
Texastruechoice $1,555 1456%
Coventry $1,838 1721%
First Health $1,838 1721%
Healthsmart $1,980 1854%
Interlink $1,980 1854%
Multiplan $2,121 1986%
USA Health Network $2,404 2251%
Mhealth Network $2,828 2648%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 17400 St Lukes Way, The Woodlands, TX 77384
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals