Ultrasound, pelvis
Facility: Physicians Care Surgical Hospital
Billing Code: 76856 (CPT)
- CPT Billing Code: 76856
- Insurance Median: $412
- Cash Discount Price: $316
- vs. Medicare Baseline: 3.86x 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 386% of the Medicare baseline (a markup of 286%). 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 |
|---|---|---|
| Connecticare | $124 | 116% |
| Blue Cross Blue Shield | $194 - $427 | 182% |
| Highmark | $194 | 182% |
| Cigna | $395 | 370% |
| Unified Health Services | $395 | 370% |
| Tricare | $395 | 370% |
| Personal Choice 65 | $395 | 370% |
| Gpm Health and Life Insurance Mc Supplement | $395 | 370% |
| Keystone 65 HMO | $395 | 370% |
| Vibra Health Plan | $395 | 370% |
| Devon Health Services | $395 | 370% |
| Ibc Security 65 | $395 | 370% |
| UnitedHealthcare | $395 - $839 | 370% |
| Humana | $395 | 370% |
| Shenandoah Life | $395 | 370% |
| Aetna | $395 - $443 | 370% |
| Aarp | $395 | 370% |
| Medicare (plans) | $395 | 370% |
| Pcsh Aarp | $395 | 370% |
| Geha | $412 | 386% |
| Lucent Health | $412 | 386% |
| Coventry | $412 | 386% |
| Healthez | $412 | 386% |
| Ag Administrators | $412 | 386% |
| Trustmark | $412 | 386% |
| Continental Benefits | $412 | 386% |
| Allied Benefits Systems | $412 | 386% |
| Marpai Health | $412 | 386% |
| Meritain Health | $412 | 386% |
| Allied Benefit Systems | $412 | 386% |
| Premier Care Network | $412 | 386% |
| Ag Administrators Inc | $412 | 386% |
| Regence Blue Shield | $427 | 400% |
| Empire Plan | $427 | 400% |
| Ibc 2021 | $427 | 400% |
| Independence Federal | $427 | 400% |
| Horizon of New Jersey | $427 | 400% |
| Keystone Healthplan East | $427 | 400% |
| Ibc - Local | $427 | 400% |
| Personal Choice | $427 | 400% |
| Amerihealth Administrators | $427 | 400% |
| Keystone HMO | $427 | 400% |
| Ibc Local | $427 | 400% |
| Amerihealth New Jersey HMO | $427 | 400% |
| Pcsh Ibc | $427 | 400% |
| Independence Administrators | $427 | 400% |
| Ibc | $427 | 400% |
| Independence Bc | $427 | 400% |
| Carefirst Administrators | $427 | 400% |
| Keystone Direct POS | $427 | 400% |
| Allsavers | $839 | 786% |
| Oxford Life Insurance Company | $839 | 786% |
| Surest | $839 | 786% |
| Oxford Health Plan | $839 | 786% |
| Golden Rule Op | $839 | 786% |