CMS Price Transparency Data

Ultrasound, pelvis

Facility: Medical Center Enterprise

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $113
  • Cash Discount Price: $626
  • vs. Medicare Baseline: 1.06x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Medical Center Enterprise is $113. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $626. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.06x the Medicare baseline. Located in 400 N Edwards Street, Enterprise, AL.
Cash / Self-Pay
$626

Average discount available for prompt cash payment at this facility.

Insurance Median
$113

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: $626 (586%)
Insurance Median: $113 (106%)
Cash: $626 (586% of Medicare)
Ins. Median: $113 (106% 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.

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
Al Maternity Waiver Program $54 51%
Medicaid / KanCare $71 - $104 66%
Tricare $86 81%
Blue Cross Blue Shield $89 - $222 83%
Humana $89 83%
Medicare (plans) $89 83%
UnitedHealthcare $89 - $224 83%
Covenant Hospice $90 84%
Dayspring Hospice $90 84%
Healthspring $90 84%
Node Champva $90 84%
Node Devoted Health Mcr Adv $90 84%
Node Hospice Non Par $90 84%
Node Va $90 84%
Select Health $90 84%
Southerncare Hospice $90 84%
Aetna $91 - $2,246 85%
Node Clover Mcr Adv $91 85%
Node Wellcare Mcr Adv $92 86%
Veterans Eval Services $92 86%
Eon Health $93 87%
Wiregrass Hospice $96 90%
Node Us Dept Of Labor $113 106%
Ambetter / Centene $135 126%
Cigna $152 - $957 142%
Occunet $158 148%
Self Pay $289 - $963 271%
American Employee Alliance $1,284 1202%
Alamed $1,925 1802%
Affordable Health $2,246 2103%
Health Choice $2,246 2103%
Novanet Ppo $2,246 2103%
Coventry Work Comp Al $2,362 2211%
Multiplan $2,375 - $2,535 2224%
Wc Dept Ind Relations $2,567 2403%
Corvel $2,728 2554%
Galaxy Health $2,888 2704%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 400 N Edwards Street, Enterprise, AL 36330
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals