CMS Price Transparency Data

Ultrasound, pelvis

Facility: Lds Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $347
  • Cash Discount Price: $614
  • vs. Medicare Baseline: 3.25x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Lds Hospital is $347. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $614. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.25x the Medicare baseline. Located in 8Th Avenue and C Street, Salt Lake City, UT.
Cash / Self-Pay
$614

Average discount available for prompt cash payment at this facility.

Insurance Median
$347

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: $614 (575%)
Insurance Median: $347 (325%)
Cash: $614 (575% of Medicare)
Ins. Median: $347 (325% 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 325% of the Medicare baseline (a markup of 225%). 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
Donor Connect $11 - $212 10%
Aetna $32 - $695 30%
American Health $32 - $105 30%
Blue Cross Blue Shield $32 - $622 30%
Health Partners Of Nevada $32 - $105 30%
Humana $32 - $110 30%
Molina $32 - $671 30%
Selecthealth $32 - $414 30%
Southwest Behavioral Health $32 - $100 30%
UnitedHealthcare $32 - $695 30%
Triwest $102 95%
Health Plan Of Nevada $105 - $245 98%
Healthy U $105 98%
Intermountain Caregiver Plan $300 - $394 281%
Awh Connected $339 - $528 317%
Byu Athletics $339 - $589 317%
Campbell Scientific $339 - $589 317%
Deseret Mutual $339 - $474 317%
Emi $339 - $442 317%
Emi Health $339 - $568 317%
Franklin County $339 - $589 317%
Ifit $339 - $589 317%
Juniper Systems $339 - $589 317%
Lw Miller $339 - $589 317%
Pehp $339 - $728 317%
Tanner Llc $339 - $589 317%
Utah Tech $339 - $589 317%
Cigna $515 - $695 482%
Byu Risk Management $573 - $597 536%
Corporation Of The President $573 - $597 536%
Wcf Insurance $573 - $597 536%
Corvel Corporation $589 551%
Managed Care Admin $589 - $638 551%
Injury Care Of Nevada $614 575%
Prodegi Corp Benefit $671 628%
Uofu $671 628%
Springtide $679 636%
Altius Mhnet Behavioral Health $695 651%
First Choice $695 651%
Global Excel $695 651%
Medcare International $695 651%
Motivhealth $695 651%
Utah Behavioral Health Network $695 651%
Wise Network $695 651%
Hygeia Corporation $736 689%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 8Th Avenue and C Street, Salt Lake City, UT 84143
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals