CMS Price Transparency Data

Ultrasound, pelvis

Facility: Holy Cross Hospital-Davis

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $539
  • Cash Discount Price: $423
  • vs. Medicare Baseline: 5.05x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Holy Cross Hospital-Davis is $539. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $423. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.05x the Medicare baseline. Located in 1600 West Antelope Drive, Layton, UT.
Cash / Self-Pay
$423

Average discount available for prompt cash payment at this facility.

Insurance Median
$539

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: $423 (396%)
Insurance Median: $539 (505%)
Cash: $423 (396% of Medicare)
Ins. Median: $539 (505% 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 505% of the Medicare baseline (a markup of 405%). 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
Select Health $40 - $520 37%
Medicaid / KanCare $56 52%
Uuhp $56 - $250 52%
Humana $64 60%
Medicare (plans) $64 60%
Employer Direct Healthcare $81 76%
Motivhealth $85 80%
Blue Cross Blue Shield $105 - $635 98%
Cigna $112 - $847 105%
Molina $150 - $455 140%
Centura Employee Plan $205 192%
Pehp $452 - $614 423%
Aetna $468 - $894 438%
Wise $550 - $561 515%
Deseret Mutual Benefit Administrators $650 609%
Multiplan $730 - $963 683%
UnitedHealthcare $767 - $1,059 718%
Emi Health $921 862%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1600 West Antelope Drive, Layton, UT 84041
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals