Ultrasound, pelvis
Facility: Salina Regional Health Center
Billing Code: 76856 (CPT)
- CPT Billing Code: 76856
- Insurance Median: $1,783
- Cash Discount Price: $1,386
- vs. Medicare Baseline: 16.69x 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 1669% of the Medicare baseline (a markup of 1569%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $129 - $136 | 121% |
| Preferred Phsic | $1,188 | 1112% |
| Preferred Healthcare - All Other Plans | $1,604 | 1502% |
| Multiplan (Mpi)-All Plans | $1,783 | 1669% |
| Cigna | $1,783 | 1669% |
| Aetna | $1,783 | 1669% |
| Providers Care (Wppa)-All Plans | $1,783 | 1669% |
Consumer Guidance & Cost Commentary
For the CPT code 76856 (Ultrasound, pelvis) at Salina Regional Health Center in Salina, KS, the facility's cash median price is $1,386.00, which is notably higher than the state average. While commercial insurance negotiated rates range from $1188.00 to $1783.00 depending on the plan, patients with high-deductible plans should consider that paying cash directly might be more cost-effective if their insurance allowed amount exceeds the cash price. It is important to verify "self-pay" or "prompt-pay" discounts with the hospital before scheduling, as these upfront payment incentives can significantly reduce the final bill by bypassing administrative processing fees and claims delays.
The facility's Medicare benchmarking data shows a charge variance of 16.7% above the Medicare rate of $106.81, which serves as the objective baseline for evaluating pricing markups. Although the median negotiated rate of $1,783.00 is higher than the cash price, patients should avoid relying on summary bills that obscure individual line items, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. To ensure fair pricing and minimize debt, consumers should request a full itemized CPT-coded bill before negotiating and dispute any discrepancies in writing to the billing supervisor rather than accepting verbal assurances.