CMS Price Transparency Data

Ultrasound, pelvis

Facility: Grandview Medical Center

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $1,514
  • Cash Discount Price: $621
  • vs. Medicare Baseline: 14.17x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Grandview Medical Center is $1,514. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $621. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 14.17x the Medicare baseline. Located in 3690 Grandview Parkway, Birmingham, AL.
Cash / Self-Pay
$621

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,514

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: $621 (581%)
Insurance Median: $1,514 (1417%)
Cash: $621 (581% of Medicare)
Ins. Median: $1,514 (1417% 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 1417% of the Medicare baseline (a markup of 1317%). 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
Encompass Health $69 65%
Medicaid / KanCare $71 66%
Tricare $91 85%
Veterans Eval Services $92 86%
Blue Advantage $94 88%
Humana $94 88%
Medicare (plans) $94 88%
UnitedHealthcare $94 - $1,947 88%
Victory Health $94 88%
Viva Health $94 - $2,379 88%
Select Health $95 89%
Cigna $96 - $170 90%
Hospice $96 90%
Node Champva $96 90%
Node Devoted Health Mcr Adv $96 90%
Node Va $96 90%
Aetna $97 - $1,203 91%
Node Clover Health Mcr Adv $97 91%
Node Wellcare Mcr Adv $98 92%
Node Us Dept Of Labor $120 112%
Ambetter / Centene $143 134%
Healthspring $167 156%
Blue Cross Blue Shield $290 272%
Self Pay $371 - $1,038 347%
Bp Health Advocate $618 - $1,082 579%
Ag Administrators $865 - $1,514 810%
Alamed $865 - $1,514 810%
Choicecare $865 - $1,514 810%
Drummond $865 - $1,514 810%
American Employee Alliance $988 - $1,730 925%
Healthchoice $1,236 - $2,596 1157%
Value Options $1,236 - $2,163 1157%
First Health $1,483 - $3,383 1388%
Multiplan $1,507 - $3,028 1411%
Blue Bell Creameries $1,730 - $3,028 1620%
Natl Comp Care $1,853 - $3,244 1735%
Usa Ppo $1,853 - $3,244 1735%
Coventry Work Comp Al $1,932 - $3,383 1809%
Novanet $1,995 - $3,493 1868%
Alabama Wc $2,100 - $3,677 1966%
Cal-Med $2,100 - $3,677 1966%
Corvel $2,100 - $3,677 1966%
Associated Admin $2,224 - $3,893 2082%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3690 Grandview Parkway, Birmingham, AL 35243
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals