CMS Price Transparency Data

Ultrasound, pelvis

Facility: Inova Alexandria Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $272
  • Cash Discount Price: $683
  • vs. Medicare Baseline: 2.55x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Inova Alexandria Hospital is $272. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $683. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.55x the Medicare baseline. Located in 4320 Seminary Rd, Alexandria, VA.
Cash / Self-Pay
$683

Average discount available for prompt cash payment at this facility.

Insurance Median
$272

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: $683 (639%)
Insurance Median: $272 (255%)
Cash: $683 (639% of Medicare)
Ins. Median: $272 (255% 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 255% of the Medicare baseline (a markup of 155%). 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
Aetna $106 - $814 99%
Blue Cross Blue Shield $106 - $282 99%
United $106 - $250 99%
Sentara Health $108 - $1,013 101%
Cigna $111 - $882 104%
Kaiser $111 - $1,065 104%
Humana $117 - $247 110%
Carefirst $343 - $372 321%
Innovation $900 843%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4320 Seminary Rd, Alexandria, VA 22304
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals